PMID- 1852134
OWN - NLM
STAT- MEDLINE
DCOM- 19910624
LR  - 20190627
IS  - 0002-9610 (Print)
IS  - 0002-9610 (Linking)
VI  - 161
IP  - 4
DP  - 1991 Apr
TI  - Rationale for development of low-molecular-weight heparins and their clinical 
      potential in the prevention of postoperative venous thrombosis.
PG  - 512-8
AB  - Interest in low-molecular-weight heparins (LMWHs) as potential antithrombotic 
      agents was stimulated by two observations in the mid-1970s and early 1980s. The 
      first was finding that LMWH fractions prepared from unfractionated heparin (UFH) 
      progressively lost their ability to prolong the activated partial thromboplastin 
      time (APTT) while retaining their ability to inhibit Factor Xa. The second was 
      the observation that LMWHs prepared by chemical depolarization of UFH are 
      antithrombotic in experimental animal models but produce less microvascular 
      bleeding in experimental models for an equivalent antithrombotic effect than the 
      UFH from which they are derived. Subsequently, it was shown that LMWHs inhibit 
      platelet function and impair vascular permeability less than standard heparin and 
      that LMWHs have a longer biological half-life than standard heparin. A number of 
      LMWHs have been evaluated in clinical trials in general and orthopedic surgery 
      and in the treatment of venous thrombosis. LMWHs are highly effective in 
      orthopedic surgery, where they appear to be more effective than standard heparin. 
      LMWHs have also been shown to be either as effective or more effective than UFH 
      in preventing postoperative thrombosis following general surgery. In preliminary 
      studies, LMWHs appear to be as effective as standard heparin in the treatment of 
      venous thrombosis, but larger studies are required using clinically relevant 
      outcome measures.
FAU - Hirsh, J
AU  - Hirsh J
AD  - Hamilton Civic Hospitals Research Centre, Henderson General Division, Ontario, 
      Canada.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Am J Surg
JT  - American journal of surgery
JID - 0370473
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Heparin, Low-Molecular-Weight/isolation & purification/pharmacology/*therapeutic 
      use
MH  - Humans
MH  - Postoperative Complications/*prevention & control
MH  - Thrombophlebitis/*prevention & control
RF  - 73
EDAT- 1991/04/01 00:00
MHDA- 1991/04/01 00:01
CRDT- 1991/04/01 00:00
PHST- 1991/04/01 00:00 [pubmed]
PHST- 1991/04/01 00:01 [medline]
PHST- 1991/04/01 00:00 [entrez]
AID - 0002-9610(91)91123-Z [pii]
AID - 10.1016/0002-9610(91)91123-z [doi]
PST - ppublish
SO  - Am J Surg. 1991 Apr;161(4):512-8. doi: 10.1016/0002-9610(91)91123-z.