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Low-molecular-weight heparin therapy for non-ST-elevation acute coronary syndromes and during percutaneous coronary

Dean J Kereiakes1, Gilles Montalescot, Elliott M Antman

  • 1Lindner Center for Research and Education and The Ohio Heart Health Center, Cincinnati, Ohio 45219, USA. lindner@fuse.net

American Heart Journal
|October 3, 2002
PubMed

Insights

Low-molecular-weight heparin (LMWH) can be safely used in acute coronary syndromes (ACS) patients undergoing cardiac procedures. Combining LMWH with glycoprotein IIb/IIIa inhibitors does not increase major bleeding risk, offering new therapeutic algorithms.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Acute coronary syndromes (ACS) benefit from low-molecular-weight heparin (LMWH) or glycoprotein (GP) IIb/IIIa inhibitors.
  • Lack of clear guidelines for LMWH use in ACS, especially during transition to intervention and with GP IIb/IIIa inhibitors.

Framework:

  • An international task force formulated consensus recommendations for LMWH use in non-ST-elevation ACS.
  • Recommendations based on evidence from randomized trials, observational studies, and expert consensus.

Implementation:

  • LMWH is safe for patients undergoing cardiac catheterization and percutaneous coronary intervention.
  • Transition from medical management to interventional procedures is facilitated by upstream LMWH use.

Implications:

  • LMWH and GP IIb/IIIa receptor antagonists can be safely combined without increasing major bleeding.
  • Consensus algorithms are provided for seamless integration of LMWH therapy in ACS management.
Abstract

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