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[Heparins].

G A Marbet1

  • 1Hämostaselabor DZL, Kantonsspital Basel. gmarbet@uhbs.ch

Therapeutische Umschau. Revue Therapeutique
|March 18, 2003
PubMed
Summary
This summary is machine-generated.

Low-molecular-weight heparins (LMWH) offer a better risk-benefit profile than unfractionated heparin (UH) for most anticoagulation needs. LMWH is preferred for venous thromboembolism and arterial occlusions, with a lower risk of heparin-induced thrombocytopenia.

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Area of Science:

  • Pharmacology
  • Hematology
  • Thrombosis Research

Context:

  • Unfractionated heparin (UH) and low-molecular-weight heparins (LMWH) are crucial antithrombotic agents.
  • LMWH has largely replaced UH for venous thromboembolism (VTE) and arterial occlusions due to improved safety and convenience.
  • Heparin-induced thrombocytopenia (HIT) risk is significantly lower with LMWH.

Purpose:

  • To compare the efficacy and monitoring of unfractionated heparin (UH) and low-molecular-weight heparins (LMWH).
  • To review the current indications and monitoring strategies for UH and LMWH in anticoagulation therapy.
  • To highlight the advantages of LMWH over UH in most clinical scenarios.

Summary:

  • LMWH offers a more favorable risk-benefit profile than UH, with a tenfold lower risk of HIT.

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  • UH is reserved for complex cases requiring rapid reversal of anticoagulation.
  • Monitoring of UH involves aPTT, TT, or anti-Xa assays, while LMWH monitoring is typically only needed in specific populations (pregnant women, children, renal impairment).
  • Therapeutic ranges for UH infusion and subcutaneous LMWH are established, guiding dose adjustments.

    • Impact:

    • Provides guidance on the appropriate use and monitoring of UH and LMWH.
    • Supports the transition towards LMWH for routine anticoagulation, improving patient safety.
    • Informs clinical practice regarding the selection of anticoagulants based on patient-specific factors and risk profiles.