A Comparison of Low-Molecular-Weight Heparin with Unfractionated Heparin for Unstable Coronary Artery Disease
New England Journal of MedicinePublished 14 August 1997Open access
Marc J. Cohen, Christine Demers, Enrique Gurfinkel, Alexander G.G. Turpie, Gregg Fromell, Shaun Goodman
Citations1,432
SJR quartileQ1
SJR score19.08
SNIP13.47
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
Antithrombotic therapy with enoxaparin plus aspirin was more effective than unfractionated heparin plus aspirin in reducing the incidence of ischemic events in patients with unstable angina or non-Q-wave myocardial infarction in the early phase.
Abstract
Antithrombotic therapy with enoxaparin plus aspirin was more effective than unfractionated heparin plus aspirin in reducing the incidence of ischemic events in patients with unstable angina or non-Q-wave myocardial infarction in the early phase. This benefit of enoxaparin was achieved with an increase in minor but not in major bleeding.
Keywords
Medicine
New England Journal of MedicineHeparin-Induced Thrombocytopenia in Patients Treated with Low-Molecular-Weight Heparin or Unfractionated Heparin
2,337 Citations1995Theodore E. Warkentin, Mark N. Levine +5 more
Daily platelet counts in 665 patients in a randomized, double-blind clinical trial comparing unfractionated heparin with low-molecular-weight hepar in as prophylaxis after hip surgery revealed heparIn-induced thrombocytopenia, associated thromBotic events, and heParin-dependent IgG antibodies are more common in patients treated with unfractionate heparine than in those treated with low,molecules-weight He
New England Journal of MedicineAspirin, Heparin, or Both to Treat Acute Unstable Angina
1,278 Citations1988Pierre Théroux, Hélène Ouimet +11 more
It is concluded that in the acute phase of unstable angina, either aspirin or heparin treatment is associated with a reduced incidence of myocardial infarction, and there is a trend favoringHeparin over aspirin.
New England Journal of MedicineA Comparison of Low-Molecular-Weight Heparin Administered Primarily at Home with Unfractionated Heparin Administered in the Hospital for Proximal Deep-Vein Thrombosis
1,198 Citations1996Mark Levine, Michael Gent +17 more
Low-molecular-weight heparin can be used safely and effectively to treat patients with proximal deep-vein thrombosis at home.
New England Journal of MedicineTreatment of Venous Thrombosis with Intravenous Unfractionated Heparin Administered in the Hospital as Compared with Subcutaneous Low-Molecular-Weight Heparin Administered at Home
1,120 Citations1996Maria M.W. Koopman, Paolo Prandoni +14 more
In patients with proximal-vein thrombosis, treatment with low-molecular-weight heparin at home is feasible, effective, and safe.
BloodLow molecular weight heparin
903 Citations1992J. Hirsh, Levine Mn
The mechanism for the difference between the anticoagulant profiles of LMWHs and SH has been elucidated and studies of platelet function and vascular permeability have provided plausible explanations for the reduced experimental bleeding observed with LMWHs.
The LancetRisk of myocardial infarction and death during treatment with low dose aspirin and intravenous heparin in men with unstable coronary artery disease
780 Citations1990The RISC Group
Aspirin reduced event rate in non-Q-wave MI and unstable angina, independently of electrocardiographic abnormalities or concurrent drug therapy and Heparin had no significant influence on event rate, although the group treated with aspirin and heparin had the lowest number of events during the initial 5 days.
RePub (Erasmus University, Rotterdam)A comparison of recombinant Hirudin with Heparin for the treatment of acute coronary syndromes. The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIb Investigators
706 Citations1996Maarten L. Simoons
New England Journal of MedicineSubcutaneous Low-Molecular-Weight Heparin Compared with Continuous Intravenous Heparin in the Treatment of Proximal-Vein Thrombosis
703 Citations1992Russell D. Hull, Gary E. Raskob +16 more
The LancetLow-molecular-weight heparin during instability in coronary artery disease
686 Citations1996Fragmin during Instability in Coronary Artery Disease (FRISC) study group
The LancetLow-molecular-weight heparin versus standard heparin in general and orthopaedic surgery: a meta-analysis
673 Citations1992Michael T. Nurmohamed, Harry R. Büller +6 more
There is at present no convincing evidence that in general surgery patients LMWHs, compared with standard heparin, generate a clinically important improvement in the benefit to risk ratio, but LM WHs may be preferable for orthopaedic surgery patients, in view of the larger absolute risk reduction for venous thrombosis.
New England Journal of MedicineA Comparison of Recombinant Hirudin with Heparin for the Treatment of Acute Coronary Syndromes
663 Citations1996The Global Use of Strategies to Open Occluded Coronary Arteries IIb Investigators
Recombinant hirudin provided a small advantage, as compared with heparin, principally related to a reduction in the risk of nonfatal myocardial infarction and was not associated with a greater risk of major bleeding complications.
The LancetComparison of subcutaneous low-molecular-weight heparin with intravenous standard heparin in proximal deep-vein thrombosis
588 Citations1992Paolo Prandoni, Mariarosa Carta +7 more
It is concluded that fixed-dose subcutaneous LMWH is at least as effective and safe as intravenous adjusted-dose heparin in the initial treatment of symptomatic proximal-vein thrombosis and since there is no need for laboratory monitoring with the LMWH regimen, patients with venous thromBosis can be treated at home.
CirculationComparison of Low-Molecular-Weight Heparin With Unfractionated Heparin Acutely and With Placebo for 6 Weeks in the Management of Unstable Coronary Artery Disease
531 Citations1997Werner Klein, Arnd B. Buchwald +8 more
The results add to previous evidence suggesting that the low-molecular-weight heparin dalteparin administered by twice-daily subcutaneous injection may be an alternative to unfractionated heparIn in the acute treatment of unstable angina or non-Q-wave myocardial infarction.
CirculationHirudin in Acute Myocardial Infarction
488 Citations1996Elliott M. Antman
Hemarin and hirudin have an equal effect as adjunctive therapy to TPA and streptokinase in preventing unsatisfactory outcome in patients with acute myocardial infarction.
New England Journal of MedicineLow-Molecular-Weight Heparin for the Treatment of Acute Ischemic Stroke
476 Citations1995R. Kay, Ka Sing Wong +9 more
For patients with ischemic stroke treated within 48 hours of the onset of symptoms, low-molecular-weight heparin was effective in improving outcomes at six months, and no significant differences among the groups in the occurrence of secondary outcomes were observed at 10 days.
New England Journal of MedicineReactivation of Unstable Angina after the Discontinuation of Heparin
465 Citations1992Pierre Théroux, David D. Waters +3 more
Although heparin is beneficial in treating unstable angina, the disease process may be reactivated within hours of the discontinuation of this drug.
CirculationCombination antithrombotic therapy in unstable rest angina and non-Q-wave infarction in nonprior aspirin users. Primary end points analysis from the ATACS trial. Antithrombotic Therapy in Acute Coronary Syndromes Research Group.
381 Citations1994Marc Cohen, Philip C. Adams +8 more
In nonprior aspirin users, combination antithrombotic therapy with aspirin plus anticoagulation significantly reduces recurrent ischemic events in the early phase of unstable angina.
BMJLow molecular weight heparin in prevention of perioperative thrombosis.
379 Citations1992Alain Leizorovicz, M. Haugh +3 more
Low molecular weight heparins seem to have a higher benefit to risk ratio than unfractionated heparin in preventing perioperative thrombosis and it remains to be shown in a suitably powered clinical trial whether low molecular weight Heparin reduces the risk of fatal pulmonary embolism compared withHeparin.
Journal of the American College of CardiologyLow molecular weight heparin versus regular heparin or aspirin in the treatment of unstable angina and silent ischemia
331 Citations1995Enrique Gurfinkel, Eustaquio Juan Manos +6 more
Treatment with aspirin plus a high dose of low molecular weight heparin during the acute phase of unstable angina was significantly better than treatment with aspirin alone or aspirin plus regular hepar in.
The LancetLow molecular weight versus standard heparin for prevention of venous thromboembolism after major abdominal surgery
288 Citations1993V.V. Kakkar, A.T. Cohen +7 more
The primary end point, the frequency of major bleeding, showed a 23% reduction in the LMWH group, but this difference was not significant, and the secondary safety end points revealed that LMWH was significantly better than SH.
Survey of AnesthesiologyLow Molecular Weight Versus Standard Heparin for Prevention of Venous Thromboembolism After Major Abdominal Surgery
284 Citations1993V. V. Kakkar, Alexander T. Cohen +8 more
Thrombosis and HaemostasisPrevention of Deep Vein Thrombosis after Major Knee Surgery - A Randomized, Double-Blind Trial Comparing a Low Molecular Weight Heparin Fragment (Enoxaparin) to Placebo
225 Citations1992Jacques R. Leclerc, William Geerts +7 more
It is concluded that a fixed dose regimen of enoxaparin, started post-operatively, is an effective and safe regimen for reducing the frequency of deep vein thrombosis after major knee surgery.
Journal of the American College of CardiologyDose-Ranging Trial of Enoxaparin for Unstable Angina: Results of TIMI 11A 11A list of the participating investigators and clinical centers for the TIMI 11A trial appears in the Appendix A.
165 Citations1997
Annals of Internal MedicineEfficacy and Safety of Enoxaparin to Prevent Deep Venous Thrombosis after Hip Replacement Surgery
124 Citations1994Theodore E. Spiro, Gerhard J. Johnson +5 more
This dose-ranging study was done to compare the efficacy and safety of three postoperative enoxaparin dose regimens to prevent deep venous thrombosis in patients having total hip replacement surgery and identified a clinically effective dose with a minimal risk for hemorrhagic complications.
The LancetLow-molecular weight heparin versus aspirin and dipyridamole after femoropopliteal bypass grafting
94 Citations1994RobertA. Edmondson, A. Cohen +3 more
It is concluded that low-molecular weight heparin is better than aspirin and dipyridamole in maintaining femoropopliteal-graft patency in patients with critical limb ischaemia undergoing salvage surgery.
HaemostasisMechanisms for the Antithrombotic Activity in Man of Low Molecular Weight Heparins (LMWHs)
63 Citations2009M Samama, L. Bara +1 more
Thrombin inhibition seems essential for the antithrombotic activity of both heparins, and reduction of thrombosis is a global effect to which "both anti-IIa and anti-Xa activity contribute but to a different exent" (C. Hemker et al.).
The LancetRandomised comparison of subcutaneous heparin, intravenous heparin, and aspirin in unstable angina
54 Citations1995Gian Gastone Neri Serneri, Pietro Amedeo Modesti +8 more
Subcutaneous heparin is effective in the control of myocardial ischaemia in patients with unstable angina and remained evident during follow-up, according to a randomised multicentre trial.
The American Journal of CardiologyComparison of efficacy of low molecular weight heparin (parnaparin) with that of unfractionated heparin in the presence of activated platelets in healthy subjects
41 Citations1993Giovanni Melandri, Franco Semprini +5 more
It is shown that heparin levels resulting in the usual activated partial thromboplastin time therapeutic range provide only a small anticoagulant effect in the presence of activated platelets.