The role of low-molecular-weight heparins in cardiovascular medicine
R. Hödl MD,
W. Klein MD,
R. Hödl MD
Division of Cardiology, Department of Medicine, Karl-Franzens University, Graz, Austria
Search for more papers by this authorW. Klein MD
Division of Cardiology, Department of Medicine, Karl-Franzens University, Graz, Austria
Search for more papers by this authorR. Hödl MD,
W. Klein MD,
R. Hödl MD
Division of Cardiology, Department of Medicine, Karl-Franzens University, Graz, Austria
Search for more papers by this authorW. Klein MD
Division of Cardiology, Department of Medicine, Karl-Franzens University, Graz, Austria
Search for more papers by this authorDr Ronald Hödl, Division of Cardiology, Department of Medicine, Karl-Franzens University, Auenbruggerplatz 15, A-8036 Graz, Austria. Tel.: +43 316 385 2544; fax: +43 316 385 3733; e-mail: [email protected]
Summary
Low-molecular-weight heparins (LMWHs) have been shown to be as effective and safe as unfractionated heparin (UFH) for acute phase treatment of acute coronary syndrome in the absence of ST-elevation [unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI)]. LMWHs have practical advantages over UFH, including usual lack of requirement for laboratory monitoring of the anticoagulant response because of their favourable pharmacokinetic properties, and thus represent a simpler and more cost-effective option in clinical practice. The LMWH dalteparin has been shown to provide extended therapy benefit to high-risk UA/NSTEMI patients and can provide a protective bridge until revascularization. While revascularization procedures are now an established intervention for patients with UA/NSTEMI, a new approach for patients who cannot undergo immediate catheter intervention is to continue with medical treatment until revascularization is possible. LMWHs are currently being investigated for use in the catheterization laboratory, in patients undergoing percutaneous coronary intervention procedures, and in conjunction with thrombolytics for treatment of acute myocardial infarction.
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