Abbreviations: ACD 5 absolute claudication distance; CI 5 confidence interval; INR 5 international normalized ratio; LMWH 5 low-molecular-weight heparin; MI 5 myocardial infarction; NASCET 5 North American Symptomatic Carotid Endarterectomy Trial; PGE1 5 prostaglandin E1; PGI2 5 prostaglandin I2; PTFE 5 polytetrafluoroethylene; rtPA 5 recombinant tissue plasminogen activator; tPA 5 tissue plasm...

OBJECTIVE To determine the efficacy and safety of enoxaparin compared with unfractionated heparin during percutaneous coronary intervention. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline and Cochrane database of systematic reviews, January 1996 to May 2011. STUDY SELECTION Randomised and non-randomised studies comparing enoxaparin with unfractionated heparin during perc...

pattern — no improvement in early reperfusion, but there was a reduced rate of recurrent myocardial infarction. In streptokinase-treated patients, TIMI grade 3 flow at 20–28 h later tended to be higher in patients treated with dalteparin (68% vs 51% for unfractionated heparin, P=0·10), and the number of ischaemic episodes on continuous ECG monitoring was lower (16% vs 38%, P=0·04) with similar ...

BACKGROUND The manifestations, complications, and outcomes of cardiovascular disease differ between women and men. The safety and efficacy of pharmacological reperfusion therapy in women with ST-elevation myocardial infarction are of particular interest. METHODS AND RESULTS We investigated outcomes in the Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment-Thromb...

Hypersensitivity to heparin and heparin-like compounds is a rare condition that represents therapeutic challenges for patients requiring a cardiopulmonary bypass (CPB). We here report the case of a woman with a combined allergy to heparins (fractionated and unfractionated), danaparoid and fondaparinux. She underwent a mitral valve replacement under CBP using lepirudin for systemic anticoagulati...

The central role of thrombin in the initiation and propagation of intravascular thrombus provides a strong rationale for direct thrombin inhibitors in acute coronary syndromes (ACS). Direct thrombin inhibitors are theoretically likely to be more effective than indirect thrombin inhibitors, such as unfractionated heparin or low-molecular-weight heparin, because the heparins block only circulatin...

AIMS In ISAR-REACT 3, 30-day outcomes in 4570 biomarker negative patients undergoing percutaneous coronary intervention (PCI) > or =2 h after pre-treatment with 600 mg of clopidogrel revealed less bleeding with bivalirudin compared with unfractionated heparin, but no difference in 30-day net clinical benefit. The objective of the present analysis was to assess the impact of bivalirudin vs. hepa...

Heparin, a sulfated polysaccharide, has been used as a clinical anticoagulant for over 90 years. Newer anticoagulants, introduced for certain specialized applications, have not significantly displaced heparin and newer heparin-based anticoagulants in most medical procedures. This chapter, while reviewing anticoagulation and these newer anticoagulants, focuses on heparin-based anticoagulants, in...