PMID- 11479487
OWN - NLM
STAT- MEDLINE
DCOM- 20010830
LR  - 20190626
IS  - 0002-8703 (Print)
IS  - 0002-8703 (Linking)
VI  - 142
IP  - 2 Suppl
DP  - 2001 Aug
TI  - Recent advances in anticoagulant therapy for acute coronary syndromes.
PG  - S22-9
AB  - BACKGROUND: Despite major advances in the treatment of acute coronary syndromes 
      (ACS), ischemic heart disease is still the leading cause of death in the 
      industrialized world. Although unfractionated heparin (UFH) has been the 
      anticoagulant of choice in ACS treatments, both low-molecular-weight heparins and 
      direct thrombin inhibitors are at least as effective as UFH in comparative 
      clinical trials. UFH has been linked to a discontinuation rebound in thrombin 
      generation, which is associated with greater ischemic end points than those with 
      the direct thrombin inhibitor hirudin. Furthermore, UFH can increase platelet 
      activation in ACS. METHODS: This review summarizes the investigation of new 
      molecular approaches to further improve clinical outcomes in ACS. RESULTS: The 
      more recently developed synthetic pentasaccharide Org31540/SR90107A provides 
      potent antithrombotic activity through selective inhibition of Factor Xa by 
      high-affinity binding to antithrombin III. Unlike UFH, the pentasaccharide does 
      not bind platelet factor 4 and is not associated with platelet activation. New 
      approaches to coronary thrombosis prevention/treatment that involve inhibition 
      higher up the extrinsic coagulation pathway have been suggested. In view of its 
      undesirable features, UFH may become obsolete with the advent of newer 
      antithrombotic agents. CONCLUSIONS: Applications for the pentasaccharide and 
      other new anticoagulants await results from definitive, large-scale trials.
FAU - Topol, E
AU  - Topol E
AD  - Department of Cardiology, the Cleveland Clinic, Cleveland, OH 44195, USA. 
      topole@ccf.org
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Oligosaccharides)
RN  - 0 (SR 90107A-ORG 31540)
RN  - 9000-94-6 (Antithrombin III)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/*therapeutic use
MH  - Antithrombin III/*therapeutic use
MH  - Clinical Trials as Topic
MH  - Heparin/therapeutic use
MH  - Heparin, Low-Molecular-Weight/therapeutic use
MH  - Hirudin Therapy
MH  - Humans
MH  - Myocardial Infarction/*prevention & control
MH  - Oligosaccharides/*therapeutic use
MH  - Syndrome
RF  - 15
EDAT- 2001/08/02 10:00
MHDA- 2001/08/31 10:01
CRDT- 2001/08/02 10:00
PHST- 2001/08/02 10:00 [pubmed]
PHST- 2001/08/31 10:01 [medline]
PHST- 2001/08/02 10:00 [entrez]
AID - a117034 [pii]
AID - 10.1067/mhj.2001.117034 [doi]
PST - ppublish
SO  - Am Heart J. 2001 Aug;142(2 Suppl):S22-9. doi: 10.1067/mhj.2001.117034.