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European Heart Journal 2004 25(19):1667-1669; doi:10.1016/j.ehj.2004.07.028
Copyright © 2004 by the European Society of Cardiology.
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Editorial

Enoxaparin in non-ST segment elevation acute coronary syndromes: duration of therapy is essential to benefit

Philippe Gabriel Steg1 and Jean-Michel Juliard

Hopital Bichat-Claude Bernard, Service de Cardiologie, Assistance Publique – Hopitaux de Paris, 46, Rue Henri Huchard, 75877 Paris Cedex 18, France

The first 150 words of the full text of this article appear below.

This editorial refers to "Enoxaparin verson 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"{dagger} by J.A. de Lemos et al. on page 1688

The topic of anticoagulation in acute coronary syndromes (ACS) is one certain to exact controversy among cardiologists. There are several clinical trials published, and meta-analyses are available, with differing results depending on which trials and which evaluation criteria are considered, allowing us to choose the one suiting our personal belief. Unfractionated heparin (UFH) used to be the standard of care for anticoagulation in ACS. Yet, it is a difficult anticoagulant to manage, largely because of a narrow therapeutic window therefore requiring careful monitoring by the activated partial thromboplastin time (aPTT). In addition, UFH is unable to inhibit clot-bound thrombin, and is associated with platelet activation. Even within the carefully monitored context . . . [Full Text of this Article]


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Related articles in EHJ:

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
James A. de Lemos, Michael A. Blazing, Stephen D. Wiviott, William E. Brady, Harvey D. White, Keith A.A. Fox, Joanne Palmisano, Karen E. Ramsey, David W. Bilheimer, Eldrin F. Lewis, M. Pfeffer, Robert M. Califf, Eugene Braunwald, and for the A to Z Investigators
EHJ 2004 25: 1688-1694. [Abstract] [Full Text]  



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T. J. Gluckman, M. Sachdev, S. P. Schulman, and R. S. Blumenthal
A Simplified Approach to the Management of Non-ST-Segment Elevation Acute Coronary Syndromes
JAMA, January 19, 2005; 293(3): 349 - 357.
[Abstract] [Full Text] [PDF]