Antithrombotic Therapy in Coronary Ischaemia: The Expanding Role of Low-Molecular-Weight Heparin

Low-molecular-weight heparins (LMWHs) have been rigorously evaluated in the management of acute coronary ischaemia. The results of clinical trials suggest that LMWHs are effective in reducing major ischaemic outcomes in patients with unstable angina and non-Q-wave myocardial infarction. In one study, LMWH was shown to be more effective than heparin. The clinical utility of LMWHs given subcutaneously in a fixed-dose without the need for monitoring results in major cost savings. The accumulating evidence suggests that LMWHs are safe, effective alternatives to standard heparin in unstable coronary disease and offer practical and therapeutic advantages, representing an important advance in the management of acute coronary ischaemia.