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BACKGROUND Low-molecular-weight heparin (LMWH) has been suggested as providing safe, efficient, convenient and possibly more cost-effective anticoagulation for haemodialysis (HD) than unfractionated heparin, with fewer side-effects and possible benefits on uraemic dyslipidaemia. METHODS In this prospective, randomized, cross-over study we compared the safety, clinical efficacy and cost effect...

CRD summary This review assessed the effect of using enoxaparin, a low molecular weight heparin, as an additional therapy with fibrinolytic treatment (such as streptokinase) in people with ST-segment elevation acute myocardial infarction. The authors concluded that enoxaparin was more effective than unfractionated heparin. However, the rates of major bleeding when using enoxaparin were signific...

Direct thrombin inhibitors inactivate thrombin without the need for antithrombin and some inactivate not only thrombin but also fibrin-bound thrombin. Hirudin has been shown to be more effective than low-dose unfractionated heparin and low molecular weight heparin for the prevention of deep vein thrombosis in high-risk orthopaedic patients. Major studies are assessing the value of direct thromb...

Heparin is a natural agent with antithrombotic action, commercially available for therapeutic use as unfractionated heparin and low molecular weight heparin. Heparin-induced thrombocytopenia (HIT) is a serious adverse reaction to heparin that promotes antibody-mediated platelet activation. HIT is defined as a relative reduction in platelet count of 50% (even when the platelet count at its lowes...

Despite dramatic advances in percutaneous coronary intervention, including coronary stents and potent antiplatelet agents, unfractionated heparin remains the standard procedural anticoagulant. Tradition and habit may have considerable influence over dose selection. A review of the role and dosage of heparin during PCI appears to be overdue

Background In the ACUITY trial, 13,819 patients with moderateor high-risk acute coronary syndromes (ACS) were randomized to heparin (unfractionated or enoxaparin) plus glycoprotein IIb/IIIa inhibition (GPI), bivalirudin plus GPI, or bivalirudin monotherapy. Compared with heparin plus GPI, bivalirudin monotherapy resulted in similar protection from ischemic events with less major bleeding. Wheth...

ABBREVIATIONS IN THIS CHAPTER ACS Acute coronary syndrome BMS Bare metal stent CABG Coronary artery bypass grafting DAPT Dual antiplatelet therapy DES Drug-eluting stent GPI Glycoprotein IIb/IIIa inhibitor HIT Heparin-induced thrombocytopenia NSTE ACS Non–ST-segment elevation acute coronary syndrome PCI Percutaneous coronary intervention STEMI ST-segment elevation myocardial infarction UA Unsta...

Unfractionated heparin (UFH) is associated with a high rate of drug-related problems due to either its inherent pharmacologic properties or an extension of these properties often caused by medication errors. The drug-related problems associated with UFH can significantly hinder the success of therapy and negatively affect the overall cost of care. Unfractionated heparin has been classified as a...