PMID- 9790285
OWN - NLM
STAT- MEDLINE
DCOM- 19981221
LR  - 20071115
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 19 Suppl K
DP  - 1998 Sep
TI  - Current roles and future possibilities for low-molecular-weight heparins in 
      unstable angina.
PG  - K18-23
AB  - Intravenous unfractionated heparin (UFH) is associated with several limitations, 
      including short duration of action, poor bioavailability, unpredictable 
      anticoagulant response, a risk of heparin-induced thrombocytopenia (HIT), and 
      disease reactivation following early discontinuation. Because of these 
      limitations, there is interest in the development of newer antithrombotic 
      strategies. Low-molecular-weight heparins (LMWHs) offer potential benefits over 
      standard heparin and allow the opportunity for subcutaneous self-administration 
      for longer periods. In the acute phase of unstable angina, LMWHs have been shown 
      to be superior to placebo and at least as effective as UFH in reducing death, 
      myocardial infarction and recurrent angina. Trials of longer-term therapy with 
      LMWHs are in progress. Although animal studies have suggested that LMWHs, by 
      reducing neo-intimal proliferation, may prevent restenosis following coronary 
      angioplasty, clinical trials have been disappointing. However, an initial study 
      with the LMWH enoxaparin (Lovenox/Clexane) and ticlopidine after elective 
      stenting (ENTICES) showed a reduction in stent thrombosis and ischaemic events. 
      This has led to a further trial of antiplatelet therapy versus Lovenox plus 
      antiplatelet therapy for patients with an increased risk of stent thrombosis 
      (ATLAST). Further studies are assessing the role of diffusion and pressure-driven 
      and mechanical devices to deliver high and sustained local intravascular 
      concentrations of heparin.
FAU - Purcell, H
AU  - Purcell H
AD  - Royal Brompton & Harefield NHS Trust, London, UK.
FAU - Fox, K M
AU  - Fox KM
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Angina, Unstable/*drug therapy/surgery
MH  - Animals
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Clinical Trials as Topic
MH  - Coronary Thrombosis/etiology/prevention & control
MH  - Heparin, Low-Molecular-Weight/administration & dosage/*therapeutic use
MH  - Humans
MH  - Injections, Subcutaneous
MH  - Postoperative Complications/etiology/prevention & control
MH  - Stents/adverse effects
MH  - Treatment Outcome
RF  - 42
EDAT- 1998/10/28 00:00
MHDA- 1998/10/28 00:01
CRDT- 1998/10/28 00:00
PHST- 1998/10/28 00:00 [pubmed]
PHST- 1998/10/28 00:01 [medline]
PHST- 1998/10/28 00:00 [entrez]
PST - ppublish
SO  - Eur Heart J. 1998 Sep;19 Suppl K:K18-23.