PMID- 11096650
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 1523-3839 (Print)
IS  - 1523-3839 (Linking)
VI  - 2
IP  - 1
DP  - 2000 Feb
TI  - Low Molecular Weight Heparin and Coronary Intervention.
PG  - 49-59
AB  - For more than 25 years, basic experiments using cell culture and animal 
      experimental techniques have predicted superior thrombin inhibition with use of 
      low molecular weight heparin (LMWH) rather than unfractionated heparin (UFH). 
      This should have application in the cardiac laboratory, where thrombin control is 
      essential to securing a safe and optimal therapeutic angioplasty for patients 
      with atherosclerotic heart disease. Despite much interest, few meaningful 
      clinical studies have been completed and there are limited clinical data to 
      establish the magnitude of benefit actually conferred through use of LMWH rather 
      than UFH among most patients undergoing elective or urgent cardiac 
      catheterization procedures. At this point, the available data suggest minimal 
      clinical advantage is to be gained through the use of LMWH over UFH. Also, 
      obtaining this modest advantage may require an extended period of drug therapy 
      before and after intervention. Any benefit conferred is likely restricted to the 
      period shortly after coronary intervention. On the other hand, available data 
      suggest that serious bleeding should not be problematic despite difficulties 
      measuring that antithrombin effect among patients receiving LMWH, even when it is 
      combined with potent platelet inhibitor therapy. Although cell culture and animal 
      experiments suggest that heparin compounds should be effective in limiting 
      intimal hyperplasia (and therefore clinical restenosis) after angioplasty, 
      randomized clinical trials have failed thus far to show any restenosis benefit 
      for either UFH or LMWH. Ongoing studies will clarify the use of combining LMWH 
      with potent antiplatelet agents as combined medical adjuncts to coronary 
      intervention.
FAU - Garratt, KN
AU  - Garratt KN
AD  - Adult Cardiac Laboratory, Mayo Graduate School of Medicine, Mayo Clinic and 
      Foundation, 200 First Street, SW, Rochester, MN 55905, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Interv Cardiol Rep
JT  - Current interventional cardiology reports
JID - 100888981
EDAT- 2000/11/30 00:00
MHDA- 2000/11/30 00:01
CRDT- 2000/11/30 00:00
PHST- 2000/11/30 00:00 [pubmed]
PHST- 2000/11/30 00:01 [medline]
PHST- 2000/11/30 00:00 [entrez]
PST - ppublish
SO  - Curr Interv Cardiol Rep. 2000 Feb;2(1):49-59.