January 20, 2003Cochrane library
Low molecular weight heparins versus unfractionated heparin for acute coronary syndromes
Why the study?
Does subcutaneous LMWH reduce mortality and ischemic events compared to intravenous UFH in patients with acute coronary syndromes?
Structured PICO
Does subcutaneous LMWH reduce mortality and ischemic events compared to intravenous UFH in patients with acute coronary syndromes?
P
Population
11,092 participants with acute coronary syndromes (unstable angina or non-ST segment elevation MI) pooled from 7 RCTs.
I
Intervention
Subcutaneous low molecular weight heparins (LMWH)
C
Comparator
Intravenous unfractionated heparin (UFH)
O
Outcome
Overall mortalityhard clinical
LMWH is a safe and effective alternative to UFH in acute coronary syndromes, reducing the risk of MI, revascularization, and thrombocytopenia without increasing bleeding.
Limitations
- Insufficient data to compare different types of LMWH
- Need for longer follow-up
Authors
Discussion
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Implication
Supports LMWH over UFH in ACS to reduce ischemic events; confirms pooled RCT benefits without mortality difference.
Cite This Study
Magee et al. (2003) studied this question.