The role of low-molecular-weight heparin in cardiovascular diseases.
Unfractionated heparin continues to have important limitations in clinical practice. It has an inconsistent anticoagulant effect, needs frequent monitoring, and is inactivated by several plasma proteins. Low-molecular-weight heparins have a more predictable anticoagulant effect than unfractionated heparin, are easier to administer, and may not require monitoring. The anticoagulation effect of low-molecular-weight heparins is caused by a combination of inhibition of thrombin generation and inhibition of thrombin activity. Low-molecular-weight heparins have now been evaluated for a number of cardiovascular conditions and have been found to be safe and effective. We review and summarize the existing data regarding the use of low-molecular-weight heparins in cardiovascular diseases, including venous thromboembolism, percutaneous coronary interventions, and acute coronary syndromes such as ST-segment elevation myocardial infarction.
Mukherjee
Debabrata
D
Division of Cardiology, University of Michigan, Ann Arbor, USA.
Topol
Eric J
EJ
D000789:Angina, Unstable / Q000188:drug therapy; D006328:Cardiac Catheterization / Q000379:methods; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D039661:Integrin beta3 / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000188:drug therapy; D040201:Platelet Membrane Glycoprotein IIb / Q000627:therapeutic use; D013923:Thromboembolism / Q000188:drug therapy
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D039661:Integrin beta3; D040201:Platelet Membrane Glycoprotein IIb