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Updated: Aug 19, 2026

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

Evolving role of low-molecular-weight heparins in ST-elevation myocardial infarction

James S Kalus1, Lynette R Moser

  • 1Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Avenue, Detroit, MI 47201, USA.

The Annals of Pharmacotherapy
|February 11, 2005
PubMed

Insights

Low-molecular-weight heparin (LMWH) shows no benefit in ST-elevation myocardial infarction (STEMI) without fibrinolysis. Enoxaparin is a viable alternative to unfractionated heparin (UFH) with fibrin-specific fibrinolytic therapy for STEMI patients.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • ST-elevation myocardial infarction (STEMI) is a critical condition requiring prompt treatment.
  • Low-molecular-weight heparin (LMWH) is an anticoagulant used in cardiovascular medicine.

Purpose of the Study:

  • To evaluate the efficacy and safety of LMWH in STEMI patients.
  • To compare LMWH with standard treatments like fibrinolytic therapy and conservative management.

Main Methods:

  • A comprehensive literature search was conducted using MEDLINE (1966-March 2004).
  • Keywords included myocardial infarction, STEMI, LMWH, enoxaparin, and dalteparin.
  • All human trials involving LMWH for STEMI were reviewed.

Main Results:

  • LMWH did not demonstrate benefits in STEMI cases managed without fibrinolytic therapy.
  • Enoxaparin showed comparable outcomes to unfractionated heparin (UFH) with non-specific fibrinolysis.
  • Enoxaparin reduced composite endpoints, mainly reinfarction, when used with fibrin-specific fibrinolysis compared to UFH.
  • Bleeding rates with LMWH and fibrinolytic agents were similar to UFH.

Conclusions:

  • Enoxaparin is a suitable alternative to UFH for STEMI patients receiving fibrin-specific fibrinolytic therapy.
  • LMWH offers no advantage over standard care for STEMI patients on non-specific fibrinolysis or conservative management.
  • Ongoing large clinical trials are expected to provide further definitive recommendations.
Abstract

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