Why the study?
Do low-molecular-weight heparins improve outcomes in patients with coronary arterial thrombus disease compared to antiplatelet agents or unfractionated heparin?
Do low-molecular-weight heparins improve outcomes in patients with coronary arterial thrombus disease compared to antiplatelet agents or unfractionated heparin?
Low-molecular-weight heparins do not appear to offer superior benefits over standard antiplatelet agents post-angioplasty or unfractionated heparin in unstable angina.
LMWH should not supplant antiplatelet agents post-PTCA or therapeutic UFH in unstable angina; leaves open need for prospective RCTs.
Popularity of low-molecular-weight heparins (LMWH) continues to grow. Clinical trials established their efficacy for various venous thromboembolic disease states. Their use in arterial disorders is also becoming widespread. Unfortunately, clinical trials in this population subgroup are either lacking or show little or no benefit of LMWH. Specifically, they appear to offer no benefit over antiplatelet agents, such as aspirin and ticlopidine, after percutaneous transluminal coronary angioplasty. Conversely, they may have a role in the management of unstable angina. At this time, however, their efficacy appears equivalent only to therapeutic dosages of unfractionated heparin.
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Daniel P. Rodman (1998) studied this question.
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