PMID- 11981112
OWN - NLM
STAT- MEDLINE
DCOM- 20020607
LR  - 20191105
IS  - 0929-5305 (Print)
IS  - 0929-5305 (Linking)
VI  - 12
IP  - 3
DP  - 2001 Dec
TI  - Low molecular weight heparin and unfractionated heparin in the early 
      pharmacologic management of acute coronary syndromes: a meta-analysis of 
      randomized clinical trials.
PG  - 289-95
AB  - BACKGROUND: The standard of care in Acute Coronary Syndromes (ACS) includes a 
      full complement of antischemic and antithrombotic therapy. Although aspirin is 
      used widely and concomitant anticoagulation is recommended, the comparative 
      benefits of low molecular weight heparin (LMWH) and unfractionated heparin (UFH) 
      have not been defined. METHODS/RESULTS: A meta-analysis including all randomized 
      clinical trials comparing LMWH and UFH for the treatment of non-ST segment 
      elevation acute coronary syndromes was performed. Risk ratios (RR), using the 
      DerSimonian-Laird Model, were calculated from a total of 13,320 patients. Death 
      (RR 0.98, 95% CI 0.73-1.31), death and myocardial infarction (MI) (RR 0.86, 95% 
      CI 0.74-1.01), death, MI, recurrent angina or revascularization (RR 0.89, 95% CI 
      0.74-1.07) and major hemorrhage (RR 1.01, 95% CI 0.81-1.25) occurred with similar 
      frequencies for the anticoagulant-based strategies. CONCLUSIONS: Fixed dose LMWH 
      therapy given subcutaneously compares favorably with UFH titrated to a target 
      level of anticoagulation and should be considered a safe, effective, and 
      clinically acceptable alternative in the early management of patients with non-ST 
      segment elevation ACS. The superiority of LMWH preparations characterized by high 
      in vitro factor Xa to thrombin inhibitory capacity is supported by clinic trial 
      data but requires further investigation.
FAU - Le Nguyen, M T
AU  - Le Nguyen MT
AD  - Cardiovascular Thrombosis Research Center, Department of Medicine, University of 
      Massachusetts Medical School, Worcester, MA 01655, USA.
FAU - Spencer, F A
AU  - Spencer FA
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PL  - Netherlands
TA  - J Thromb Thrombolysis
JT  - Journal of thrombosis and thrombolysis
JID - 9502018
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Acute Disease
MH  - Angina, Unstable/drug therapy/prevention & control
MH  - Coronary Disease/complications/*drug therapy/mortality
MH  - Disease Management
MH  - Heparin/*administration & dosage
MH  - Heparin, Low-Molecular-Weight/*administration & dosage
MH  - Humans
MH  - Myocardial Infarction/drug therapy/prevention & control
MH  - Myocardial Revascularization/statistics & numerical data
MH  - Odds Ratio
MH  - Randomized Controlled Trials as Topic
MH  - Syndrome
EDAT- 2002/05/01 10:00
MHDA- 2002/06/12 10:01
CRDT- 2002/05/01 10:00
PHST- 2002/05/01 10:00 [pubmed]
PHST- 2002/06/12 10:01 [medline]
PHST- 2002/05/01 10:00 [entrez]
AID - 10.1023/a:1015287311065 [doi]
PST - ppublish
SO  - J Thromb Thrombolysis. 2001 Dec;12(3):289-95. doi: 10.1023/a:1015287311065.