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Low-molecular-weight heparins in the management of acute coronary syndromes
P J Zed1, J E Tisdale, S Borzak
1CSU Pharmaceutical Sciences, Vancouver Hospital and Health Sciences Center, Faculty of Pharmaceutical Sciences, University of British Columbia, Canada. zed@interchange.ubc.ca
Insights
Low-molecular-weight heparins are effective treatments for acute coronary syndromes, offering advantages over traditional unfractionated heparin. This review evaluates their role in managing unstable angina and myocardial infarction.
Area of Science:
- Cardiology
- Thrombosis Management
Background:
- Acute coronary syndromes stem from atherosclerotic plaque rupture, leading to thrombosis.
- Aspirin and unfractionated heparin are standard treatments for acute coronary syndromes.
Purpose of the Study:
- To review and evaluate literature on low-molecular-weight heparins (LMWHs) in acute coronary syndrome management.
- To establish the therapeutic role of LMWHs in unstable angina and non-Q-wave myocardial infarction.
Main Methods:
- Literature review of randomized controlled trials.
- Evaluation of LMWHs versus unfractionated heparin in acute coronary syndromes.
Main Results:
- LMWHs demonstrate equal efficacy to unfractionated heparin in thromboembolic processes.
- Recent trials assess LMWHs specifically for unstable angina and non-Q-wave myocardial infarction.
Conclusions:
- LMWHs present potential advantages over unfractionated heparin.
- Further evaluation confirms the significant role of LMWHs in acute coronary syndrome therapy.
Abstract:
Acute coronary syndromes (unstable angina and non-Q-wave myocardial infarction) are caused by the rupture of an atherosclerotic plaque, platelet activation, and fibrin deposition resulting in thrombosis. Aspirin and unfractionated heparin have traditionally been the treatments of choice for patients with acute coronary syndromes. Low-molecular-weight heparins offer potential advantages over unfractionated heparin, having proven equally effective for the treatment and prevention of many thromboembolic processes. Recently, a number of randomized controlled trials have been conducted to evaluate the role of low-molecular-weight heparins in the management of patients with unstable angina or non-Q-wave myocardial infarction. The purpose of this article is to review and evaluate the available literature on the use of low-molecular-weight heparins in the management of acute coronary syndromes to establish their role in therapy.