PMID- 14965199
OWN - NLM
STAT- MEDLINE
DCOM- 20040430
LR  - 20190728
IS  - 1381-6128 (Print)
IS  - 1381-6128 (Linking)
VI  - 10
IP  - 4
DP  - 2004
TI  - Low-molecular weight heparins in percutaneous coronary interventions: current 
      concepts, problems, and perspectives.
PG  - 375-86
AB  - A growing body of evidence suggests that low molecular weight heparin (LMWH) is 
      at least as effective as unfractionated heparin (UFH) in the medical management 
      of acute coronary syndromes (ACS) including acute myocardial infarction. Several 
      studies support an early invasive as compared to a conservative (non-invasive) 
      approach utilizing percutaneous coronary intervention (PCI) in these patients. 
      During coronary angiography and PCI systemic anticoagulation usually 
      administering UFH should prevent thrombus formation at the catheter equipment and 
      at the site of vessel injury. The widespread use of UFH as the anticoagulant of 
      choice is explained by low costs, easy reversibility and accepted anticoagulant 
      properties. However, the clinical support for the use of UFH in PCI is largely 
      based on retrospective and observational data only. Compared to UFH, LMWH have 
      distinct pharmacological advantages, including ease of administration and usually 
      no need for monitoring. A major drawback of LMWH is the predominant renal 
      clearance which may lead to unpredictable levels of anticoagulation in patients 
      with impaired renal function. Since LMWH constitute an extremely heterogeneous 
      group of drugs each LMWH should be recognized as an individual pharmaceutical 
      compound. Consequently, pharmacodynamic and pharmacokinetic properties of one 
      LMWH must not be extrapolated for other LMWH. A growing body of evidence supports 
      the use of LMWH in ACS, with or without GPIIb/IIIa receptor antagonists, 
      thrombolysis, or PCI. Although in patients undergoing PCI, LMWH have yet not been 
      shown to be superior to UFH they can safely be administered.
FAU - Graf, J
AU  - Graf J
AD  - Medical Clinic I, University Hospital Aachen, Pauwelsstrasse 30, D-52074 Aachen, 
      Germany. jgraf@gmx.de
FAU - Janssens, U
AU  - Janssens U
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United Arab Emirates
TA  - Curr Pharm Des
JT  - Current pharmaceutical design
JID - 9602487
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Angioplasty, Balloon, Coronary/*adverse effects
MH  - Animals
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Blood Coagulation/*drug effects
MH  - Coronary Disease/*blood/therapy
MH  - Heparin, Low-Molecular-Weight/administration & dosage/*therapeutic use
MH  - Humans
MH  - Randomized Controlled Trials as Topic
MH  - Thrombosis/*prevention & control
RF  - 82
EDAT- 2004/02/18 05:00
MHDA- 2004/05/01 05:00
CRDT- 2004/02/18 05:00
PHST- 2004/02/18 05:00 [pubmed]
PHST- 2004/05/01 05:00 [medline]
PHST- 2004/02/18 05:00 [entrez]
AID - 10.2174/1381612043453342 [doi]
PST - ppublish
SO  - Curr Pharm Des. 2004;10(4):375-86. doi: 10.2174/1381612043453342.