Should the Non-ST Segment Elevation ACS Patient Receive Low-Molecular Weight Heparin Rather Than Unfractionated Heparin?
Low-molecular weight heparins as a class are indirect thrombin inhibitors which provide relatively more inhibition of thrombin generation than unfractionated heparin. The advantages of low-molecular weight heparin include ease of administration, no need for monitoring, less platelet stimulation, and less thrombocytopenia. A number of trials have examined the usefulness of low-molecular weight heparin in the setting of non-ST segment elevation acute coronary syndrome. The ESSENCE and TIMI-11b trials demonstrated that short-term administration of enoxaparin was associated with an 18-24% reduction in death, myocardial infarction, and urgent revascularization over the first 48 hours of therapy. A meta-analysis combining these studies, including 7,081 patients, revealed a significant 18% reduction in death or MI over the first 43 days of therapy (7.1% versus 8.6%; P = 0.02). The FRISC II trial, which also randomized patients to long-term dalteparin versus placebo, found that dalteparin admi
Related Questions
- There has been debate about the advantages of low molecular weight heparin versus unfractionated heparin. Which of our kits can measure LMW heparin?
- Should the Non-ST Segment Elevation ACS Patient Receive Low-Molecular Weight Heparin Rather Than Unfractionated Heparin?
- What is low molecular weight heparin and how does it differ from unfractionated heparin?
