Dosing considerations and monitoring of low molecular weight heparins and glycoprotein IIb/IIIa antagonists in patients with renal insufficiency.
Glycoprotein IIb/IIIa inhibitors and low molecular heparins are important new components of the medical treatment for acute coronary syndromes (ACS). Renal insufficiency is a common comorbid condition and high-risk marker for ACS. The safety and efficacy of these treatments in ACS are dependent on the pharmacokinetics of the specific medication. Even though these treatments have been studied in large randomized controlled trials in ACS, there are few prospective data regarding their safety or efficacy in renal insufficiency. Most have been shown to be safe and effective in mild to moderate degrees of renal insufficiency; none have been thoroughly studied in severe renal disease or in patients requiring dialysis therapy. Future prospective trials should include patients with more severe renal insufficiency, as well as combinations of the current recommended therapies.
Rammohan
Chidambaram
C
Northwestern University Feinberg School of Medicine, Division of Cardiology, 201 East Huron Street, Galter 10-240, Chicago, IL 60611-2908, USA.
Fintel
Dan
D
D000208:Acute Disease; D000789:Angina, Unstable / Q000188:drug therapy* / Q000209:etiology*; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000209:etiology*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000008:administration & dosage* / Q000037:antagonists & inhibitors* / Q000627:therapeutic use; D051437:Renal Insufficiency / Q000150:complications* / Q000188:drug therapy*; D013577:Syndrome
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D019039:Platelet Glycoprotein GPIIb-IIIa Complex