The Use of Low-Molecular Weight Heparins in Acute Coronary Syndromes

Acute coronary syndrome (ACS) comprises of unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI). ACS is the consequence of a sudden rupture of the coronary artery plaque and the immediate formation of thrombosis around the plaque. The presence of coronary occlusion and thrombus might result in cardiac muscle damage and loss of effective cardiac output, leading to cardiac failure. Anticoagulants, therefore, play an important role in medical management for ACS. This article assesses the role of low molecular weight heparin (LMWH) in ACS based on current available data in clinical trials and clinical practice guidelines from the American College of Cardiology (ACC)/the American Heart Association (AHA) and the American College of Chest Physicians (ACCP) antithrombotic and thrombolytic therapy consensus guidelines. Overall, the use of enoxaparin is generally preferred over other LMWHs when LMWH is indicated, and there is strong support for its role across the continuum of treatment for ACS patients.