[Low molecular weight heparin in unstable angina]

Encouraging results have been reported with non fractionated heparin in the acute treatment of unstable angina. Recent therapeutic trials have shown that some low molecular weight heparins, associated with aspirin, and prescribed in the long term after the hospital phase, have a significant beneficial effect on the frequency of clinical events. A phenomenon of reactivation with a notable increase in clinical events has clearly been demonstrated in the period following withdrawal of heparin. Data comparing non fractionated and low molecular weight heparins are scarce at present. A major question remains: the choice of therapeutic strategy after the acute phase, pharmacological or early revascularisation? Clinical trials taking pharmaco-economic aspects into consideration are required.