PMID- 10680039
OWN - NLM
STAT- MEDLINE
DCOM- 20000316
LR  - 20200225
IS  - 0160-9289 (Print)
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Linking)
VI  - 23 Suppl 1
IP  - Suppl
DP  - 2000 Jan
TI  - Long-term management--the way forward?
PG  - I13-7
AB  - The mainstay of treatment for unstable coronary artery disease (UCAD) currently 
      consists of antithrombotic therapy with aspirin plus unfractionated heparin 
      (UFH), together with anti-ischemic treatment with beta blockers and nitrates. 
      Recently, there has been a trend toward replacement of UFH with 
      low-molecular-weight heparins (LMWHs), since these products offer significant 
      advantages over the parent compound. Several lines of evidence suggest that 
      prolongation of treatment with LMWHs beyond the acute phase may be appropriate in 
      patients with UCAD. The Fragmin and Fast Revascularization during InStability in 
      Coronary artery disease (FRISC II) study was designed to evaluate this hypothesis 
      using the LMWH dalteparin sodium (Fragmin). A factorial design was used to 
      randomize patients enrolled in the FRISC II study to an invasive or noninvasive 
      management strategy, and to treatment with dalteparin sodium or placebo. 
      Treatment with dalteparin sodium significantly reduced incidences of death and/or 
      myocardial infarction (MI) during the first months of treatment (the reduction in 
      the relative risk of double endpoint events was statistically significant at 
      47.0% at 1 month, and remained so at 2 months, but was no longer statistically 
      significant at the 3-month assessment). However, risk, as defined by the triple 
      endpoint of death, MI, and revascularization, was significantly lower (13.0% 
      relative risk reduction) at 3-month follow-up in the treatment group randomized 
      to dalteparin sodium than among patients receiving placebo. In patients in whom 
      revascularization procedures were carried out, the risk of new, postprocedural 
      events was low in both the placebo and dalteparin sodium arms. Thus, dalteparin 
      sodium appears to protect patients from cardiac events until they undergo 
      invasive procedures, and it can therefore be used as a bridge to 
      revascularization.
FAU - Wallentin, L
AU  - Wallentin L
AD  - Department of Cardiology, University Hospital, Uppsala, Sweden. 
      lars.wallentin@card.uas.lul.se
LA  - eng
PT  - Clinical Trial
PT  - Controlled Clinical Trial
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - R16CO5Y76E (Aspirin)
RN  - S79O08V79F (Dalteparin)
SB  - IM
MH  - Angina, Unstable/*drug therapy
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Aspirin/therapeutic use
MH  - Coronary Artery Disease/*drug therapy
MH  - Dalteparin/therapeutic use
MH  - Drug Therapy, Combination
MH  - Heparin, Low-Molecular-Weight/adverse effects/*therapeutic use
MH  - Humans
MH  - Prospective Studies
MH  - Randomized Controlled Trials as Topic
MH  - Stroke/etiology/prevention & control
MH  - Treatment Outcome
PMC - PMC6655054
EDAT- 2000/02/19 09:00
MHDA- 2000/03/18 09:00
PMCR- 2009/02/03
CRDT- 2000/02/19 09:00
PHST- 2000/02/19 09:00 [pubmed]
PHST- 2000/03/18 09:00 [medline]
PHST- 2000/02/19 09:00 [entrez]
PHST- 2009/02/03 00:00 [pmc-release]
AID - CLC4960231305 [pii]
AID - 10.1002/clc.4960231305 [doi]
PST - ppublish
SO  - Clin Cardiol. 2000 Jan;23 Suppl 1(Suppl ):I13-7. doi: 10.1002/clc.4960231305.