Low-molecular-weight heparin use in acute coronary syndromes and percutaneous coronary interventions: An update

Based on important studies published in the past year, the role of low-molecular-weight heparin in acute coronary syndromes and percutaneous coronary interventions has continued to evolve. For patients with non-ST-elevation acute coronary syndromes, several alternatives to enoxaparin have been introduced, including fondaparinux and bivalirudin. In patients with ST-elevation myocardial infarction, recent studies have demonstrated a clear mortality benefit from adjunctive antithrombin therapy and the superiority of a prolonged course of enoxaparin over a standard duration of unfractionated heparin. Furthermore, recent data have demonstrated the safety of enoxaparin as an alternative to unfractionated heparin among patients undergoing percutaneous coronary interventions.