PMID- 18425889
OWN - NLM
STAT- MEDLINE
DCOM- 20080613
LR  - 20181221
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
IP  - 2
DP  - 2008 Apr 16
TI  - Heparin versus placebo for acute coronary syndromes.
PG  - CD003462
LID - 10.1002/14651858.CD003462.pub2 [doi]
AB  - BACKGROUND: Acute coronary syndromes (ACS) represent a spectrum of disease 
      including unstable angina (UA) and non-ST segment myocardial infarction (NSTEMI). 
      Despite treatment with aspirin, beta-blockers and nitroglycerin, UA/NSTEMI is 
      still associated with significant morbidity and mortality. Although emerging 
      evidence suggests that low molecular weight heparin (LMWH) is more efficacious 
      compared to unfractionated heparin (UFH), there is limited data to support the 
      role of heparins as a drug class in the treatment of ACS. OBJECTIVES: To 
      determine the effect of heparins (UFH and LMWH) compared with placebo for the 
      treatment of patients with ACS. SEARCH STRATEGY: We searched the Cochrane Central 
      Register of Controlled Trials on The Cochrane Library (issue 4, 2002), MEDLINE 
      (1966 to May 2002), EMBASE (1980 to May 2002) and CINAHL (1982 to May 2002). 
      Authors of included studies and pharmaceutical industry representatives were 
      contacted to determine if unpublished studies which met the inclusion criteria 
      were available. SELECTION CRITERIA: Randomized controlled trials of parenteral 
      UFH or LMWH versus placebo in people with ACS (UA or NSTEMI). DATA COLLECTION AND 
      ANALYSIS: Two reviewers independently assessed quality of studies. Data were 
      extracted independently by two reviewers. Study authors were contacted to verify 
      and clarify missing data. MAIN RESULTS: Eight studies (3118 participants) were 
      included in this review. We found no evidence for difference in overall mortality 
      between the groups treated with heparin and placebo (RR = 0.84, 95% CI 0.36 to 
      1.98). Heparins reduced the occurrence of MI (RR = 0.40, 95% CI 0.25 to 0.63, NNT 
      = 33). An increase in the incidence of minor bleeds (RR = 6.80, 95% CI 1.23 to 
      37.49, NNH = 17). AUTHORS' CONCLUSIONS: Compared to placebo, patients treated 
      with heparins had similar risk of mortality, revascularization, recurrent angina, 
      major bleeding and thrombocytopenia. However, those treated with heparins had 
      decreased risk of MI and a higher incidence of minor bleeding.
FAU - Magee, K D
AU  - Magee KD
AD  - Dalhousie University, Department of Emergency Medicine, Queen Elizabeth II Health 
      Sciences Centre, Halifax Infirmary, 1796 Summer Street, Halifax, Nova Scotia, 
      Canada B3H 3A7. kmagee@dal.ca
FAU - Campbell, S G
AU  - Campbell SG
FAU - Moher, D
AU  - Moher D
FAU - Rowe, B H
AU  - Rowe BH
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20080416
PL  - England
TA  - Cochrane Database Syst Rev
JT  - The Cochrane database of systematic reviews
JID - 100909747
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Placebos)
RN  - 9005-49-6 (Heparin)
SB  - IM
UIN - Cochrane Database Syst Rev. 2014;6:CD003462. PMID: 24972265
MH  - Acute Coronary Syndrome/*drug therapy/mortality
MH  - Angina, Unstable/drug therapy
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Heparin/adverse effects/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/adverse effects/therapeutic use
MH  - Humans
MH  - Myocardial Infarction/prevention & control
MH  - Placebos/therapeutic use
MH  - Randomized Controlled Trials as Topic
RF  - 72
EDAT- 2008/04/22 09:00
MHDA- 2008/06/14 09:00
CRDT- 2008/04/22 09:00
PHST- 2008/04/22 09:00 [pubmed]
PHST- 2008/06/14 09:00 [medline]
PHST- 2008/04/22 09:00 [entrez]
AID - 10.1002/14651858.CD003462.pub2 [doi]
PST - epublish
SO  - Cochrane Database Syst Rev. 2008 Apr 16;(2):CD003462. doi: 
      10.1002/14651858.CD003462.pub2.