The American Journal of Medicine
Volume 120, Issue 1 , Pages 63-71 , January 2007

Use of Heparins in Non-ST-Elevation Acute Coronary Syndromes

  • Joel M. Gore, MD, FACC

      Affiliations

    • University of Massachusetts Medical School, Worcester, Mass
    • Corresponding Author InformationRequests for reprints should be addressed to Joel M. Gore, MD, Division of Cardiovascular Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655.
    • ,
  • Frederick A. Spencer, MD

      Affiliations

    • University of Massachusetts Medical School, Worcester, Mass
    • ,
  • Robert J. Goldberg, PhD

      Affiliations

    • University of Massachusetts Medical School, Worcester, Mass
    • ,
  • Brian M. Kennelly, MD, PhD, FACC

      Affiliations

    • Hoag Memorial Hospital Presbyterian, Newport Beach, Calif
    • ,
  • Keith A.A. Fox, MB, ChB

      Affiliations

    • Cardiovascular Research, The University and The Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom
    • ,
  • Jeanna Allegrone, BA

      Affiliations

    • University of Massachusetts Medical School, Worcester, Mass
    • ,
  • Kim A. Eagle, MD, FACC

      Affiliations

    • The University of Michigan Cardiovascular Center, Ann Arbor, Mich
    • ,
  • Frederick A. Anderson Jr., PhD

      Affiliations

    • University of Massachusetts Medical School, Worcester, Mass
    • ,
  • Philippe G. Steg, MD, FACC

      Affiliations

    • Hôpital Bichat, Paris, France.
    • ,
  • GRACE Investigators

References 

  1. Cohen M, Adams PC, Parry G, et al. Antithrombotic Therapy in Acute Coronary Syndromes Research Group Combination antithrombotic therapy in unstable rest angina and non-Q-wave infarction in non prior aspirin users (Primary end points analysis from the ATACS trial). Circulation. 1994;89(1):81–88
  2. Cohen M, Demers C, Gurfinkel EP, et al. A comparison of low-molecular-weight heparin with unfractionated heparin for unstable coronary artery disease (Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-wave Coronary Events Study Group). N Engl J Med. 1997;337(7):447–452
  3. Antman EM, McCabe CH, Gurfinkel EP, et al. Enoxaparin prevents death and cardiac ischemic events in unstable angina/non-Q-wave myocardial infarction (Results of the thrombolysis in myocardial infarction (TIMI) 11B trial). Circulation. 1999;100(15):1593–1601
  4. Xiao Z, Theroux P. Platelet activation with unfractionated heparin at therapeutic concentrations and comparisons with a low-molecular-weight heparin and with a direct thrombin inhibitor. Circulation. 1998;97(3):251–256
  5. Warkentin TE, Levine MN, Hirsh J, et al. Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin. N Engl J Med. 1995;332(20):1330–1335
  6. Braunwald E, Antman EM, Beasley JW, et al. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction—summary article: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on the Management of Patients with Unstable Angina). J Am Coll Cardiol. 2002;40(7):1366–1374
  7. Bertrand ME, Simoons ML, Fox KA, et al. Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2002;23(23):1809–1840
  8. GRACE Investigators. Rationale and design of the GRACE (Global Registry of Acute Coronary Events) Project: a multinational registry of patients hospitalized with acute coronary syndromes. Am Heart J. 2001;141(2):190–199
  9. Steg PG, Goldberg RJ, Gore JM, et al. Baseline characteristics, management practices, and in-hospital outcomes of patients hospitalized with acute coronary syndromes in the Global Registry of Acute Coronary Events (GRACE). Am J Cardiol. 2002;90(4):358–363
  10. Granger CB, Goldberg RJ, Dabbous O, et al. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003;163(19):2345–2353
  11. Moscucci M, Fox KA, Cannon CP, et al. Predictors of major bleeding in acute coronary syndromes: the Global Registry of Acute Coronary Events (GRACE). Eur Heart J. 2003;24(20):1815–1823
  12. Blazing MA, de Lemos JA, White HD, et al. Safety and efficacy of enoxaparin vs unfractionated heparin in patients with non-ST-segment elevation acute coronary syndromes who receive tirofiban and aspirin: a randomized controlled trial. JAMA. 2004;292(1):55–64
  13. Ferguson JJ, Califf RM, Antman EM, et al. Enoxaparin vs unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndromes managed with an intended early invasive strategy: primary results of the SYNERGY randomized trial. JAMA. 2004;292(1):45–54
  14. de Lemos JA, Blazing MA, Wiviott SD, et al. Enoxaparin versus unfractionated heparin in patients treated with tirofiban, aspirin and an early conservative initial management strategy: results from the A phase of the A-to-Z trial. Eur Heart J. 2004;25(19):1688–1694

PII: S0002-9343(06)00671-1

doi: 10.1016/j.amjmed.2006.05.047

The American Journal of Medicine
Volume 120, Issue 1 , Pages 63-71 , January 2007

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