PMID- 10549727
OWN - NLM
STAT- MEDLINE
DCOM- 19991208
LR  - 20071115
IS  - 0094-6176 (Print)
IS  - 0094-6176 (Linking)
VI  - 25 Suppl 3
DP  - 1999
TI  - Differentiation of low molecular weight heparins in acute coronary syndromes: an 
      interventionalist's perspective.
PG  - 123-7
AB  - The more predictable and sustained anticoagulant effects of low molecular weight 
      heparins (LMWHs) compared with unfractionated heparin (UFH) has led to increasing 
      interest in their potential use in association with interventional cardiac 
      procedures. Available data demonstrate that dalteparin, nadroparin, reviparin and 
      enoxaparin can be safely used during percutaneous transluminal coronary 
      angioplasty. As yet there is, however, no evidence of a reduction in restenosis. 
      Preliminary evidence indicates that a novel antithrombotic combination of 
      ticlodipine and enoxaparin in association with coronary stenting may reduce the 
      frequency of acute events compared with conventional antithrombotic therapy, 
      although it remains unclear as to whether ticlopidine alone is equally effective. 
      Enoxaparin also reduces the frequency of ischemic events following thrombolytic 
      therapy for acute myocardial infarction, and is the only LMWH to have been shown 
      to reduce the frequency of revascularization procedures in patients with acute 
      coronary syndromes. Some evidence suggests that, in patients with acute coronary 
      syndromes, plaque passivation may be adequately managed using long-term LMWH 
      therapy, rather than immediate intervention, given the potential increase in 
      thromboembolic burden by the interventional procedure. On the basis of available 
      evidence, peri-interventional use of LMWH is broadly feasible. Given the United 
      States Food and Drug Administration's position that LMWHs are distinct 
      noninterchangeable drugs, further trials are needed to establish acceptable 
      protocols and the LMWH of choice. Until that time, interventional cardiologists 
      can rely on available clinical data to choose a LMWH that will simplify patient 
      management and improve patient outcome.
FAU - Gulba, D
AU  - Gulba D
AD  - Charite, Humboldt University at Berlin, Franz-Volhard Clinic, Division of 
      Clinical and Molecular Cardiology, Germany.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Semin Thromb Hemost
JT  - Seminars in thrombosis and hemostasis
JID - 0431155
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Acute Disease
MH  - Animals
MH  - Clinical Trials as Topic
MH  - Coronary Disease/*drug therapy
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Myocardial Revascularization
MH  - Syndrome
RF  - 17
EDAT- 1999/11/05 00:00
MHDA- 1999/11/05 00:01
CRDT- 1999/11/05 00:00
PHST- 1999/11/05 00:00 [pubmed]
PHST- 1999/11/05 00:01 [medline]
PHST- 1999/11/05 00:00 [entrez]
PST - ppublish
SO  - Semin Thromb Hemost. 1999;25 Suppl 3:123-7.