Why the study?
Do newer anticoagulant agents (low molecular weight heparins, anti-factor Xa agents, direct thrombin inhibitors) improve outcomes compared to conventional unfractionated heparin in patients with ST segment elevation myocardial infarction?
Do newer anticoagulant agents (low molecular weight heparins, anti-factor Xa agents, direct thrombin inhibitors) improve outcomes compared to conventional unfractionated heparin in patients with ST segment elevation myocardial infarction?
This review highlights that newer anticoagulants, such as low molecular weight heparins, anti-factor Xa agents, and direct thrombin inhibitors, are superior to conventional unfractionated heparin in STEMI patients.
May support preferring newer anticoagulants in STEMI; leaves open optimal agent and regimen selection.
New data have re-established the importance of anticoagulation of patients with ST segment elevation myocardial infarction (STEMI), both as an adjuvant to reperfusion therapy or in patients ineligible for reperfusion. Recent randomized trials have found newer agents to be superior to conventional unfractionated heparin. This article summarizes current understanding of the underlying pathophysiology of STEMI and provides a comprehensive review of emerging trial data for low molecular weight heparins, anti-factor Xa agents and direct thrombin inhibitors in this setting.
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Ian Menown (2008) studied this question.
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