Current status of the clinical use of heparin fractions

In recent years, numerous low molecular weight heparin (LMWH) fractions have become available for clinical use, and the widespread registration of some of these products is expected soon also in Italy. An increased benefit/risk ratio concerning efficacy and safety has been shown in animal models as compared to standard heparin. In order to assess whether there is sufficient evidence supporting their use in replacement of unfractionated heparin, a review of the results of the main clinical studies is performed, discussing LMWH effectiveness and bleeding risk separately in the different clinical applications.