Progress in Cardiovascular Diseases
Volume 45, Issue 2 , Pages 139-156, September 2002

The role of low-molecular–weight heparin in cardiovascular diseases

Division of Cardiology, University of Michigan, Ann Arbor, MI, and Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, OH.

Abstract 

Unfractionated heparin continues to have important limitations in clinical practice. It has an inconsistent anticoagulant effect, needs frequent monitoring, and is inactivated by several plasma proteins. Low-molecular–weight heparins have a more predictable anticoagulant effect than unfractionated heparin, are easier to administer, and may not require monitoring. The anticoagulation effect of low-molecular–weight heparins is caused by a combination of inhibition of thrombin generation and inhibition of thrombin activity. Low-molecular–weight heparins have now been evaluated for a number of cardiovascular conditions and have been found to be safe and effective. We review and summarize the existing data regarding the use of low-molecular–weight heparins in cardiovascular diseases, including venous thromboembolism, percutaneous coronary interventions, and acute coronary syndromes such as ST-segment elevation myocardial infarction. Copyright 2002, Elsevier Science (USA). All rights reserved.

Progress in Cardiovascular Diseases, Vol. 45, No. 2, (September/October) 2002: pp 139-156

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 Address reprint requests to Eric J. Topol, MD, FACC, Provost and Chief Academic Officer, Chairman, Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, F 25, 9500 Euclid Ave, Cleveland, OH 44195.

PII: S0033-0620(02)70004-2

doi:10.1053/pcad.2002.127679

Progress in Cardiovascular Diseases
Volume 45, Issue 2 , Pages 139-156, September 2002