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Low molecular weight heparins

B Cosmi1, J Hirsh

  • 1Hamilton Civic Hospitals Research Centre, Ontario, Canada.

Current Opinion in Cardiology
|September 1, 1994
PubMed
Summary
This summary is machine-generated.

Low molecular weight heparins (LMWHs) offer improved bioavailability and predictability over unfractionated heparin (UFH). LMWHs show significant advantages in orthopedic surgery for preventing venous thromboembolism and are effective for treating deep vein thrombosis.

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Area of Science:

  • Pharmacology
  • Biochemistry
  • Thrombosis Research

Background:

  • Low molecular weight heparins (LMWHs) are derived from unfractionated heparin (UFH) through depolymerization.
  • This process reduces mean molecular weight, enhancing biochemical and pharmacologic properties.

Purpose of the Study:

  • To compare the efficacy and safety of LMWHs versus UFH.
  • To evaluate LMWH advantages in various clinical settings, including surgical prophylaxis and deep vein thrombosis treatment.

Main Methods:

  • Review of clinical studies and experimental data comparing LMWH and UFH.
  • Analysis of pharmacokinetic properties, dose-response relationships, and clinical outcomes.

Main Results:

  • LMWHs demonstrate greater bioavailability, longer half-life, and more predictable dose response than UFH.

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  • Clinical studies show modest advantages in general surgery but substantial benefits in orthopedic surgery for venous thromboembolism prevention.
  • LMWHs are as effective and safe as UFH for treating deep vein thrombosis, with added benefits of simpler administration and outpatient use.
  • Conclusions:

    • LMWHs offer significant therapeutic advantages over UFH, including improved pharmacokinetics and clinical efficacy.
    • The predictable response allows for fixed dosing without laboratory monitoring, enhancing patient management.
    • LMWHs represent a valuable therapeutic option for venous thromboembolism prophylaxis and treatment, particularly in orthopedic surgery and outpatient settings.