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Monitoring of low-molecular-weight heparins in cardiovascular disease

The American journal of cardiology, 1998-09, Vol.82 (5), p.33L-36L [Peer Reviewed Journal]

1998 Excerpta Medica Inc. ;Copyright Elsevier Sequoia S.A. Sep 10, 1998 ;ISSN: 0002-9149 ;EISSN: 1879-1913 ;DOI: 10.1016/S0002-9149(98)00111-8 ;PMID: 9737479 ;CODEN: AJCDAG

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  • Title:
    Monitoring of low-molecular-weight heparins in cardiovascular disease
  • Author: Abbate, Rosanna ; Gori, Anna Maria ; Farsi, Alessandro ; Attanasio, Monica ; Pepe, Guglielmina
  • Subjects: Anticoagulants - pharmacology ; Blood Coagulation - drug effects ; Cardiovascular disease ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - prevention & control ; Drug Monitoring ; Drug therapy ; Heparin, Low-Molecular-Weight - pharmacology ; Humans ; Medical research
  • Is Part Of: The American journal of cardiology, 1998-09, Vol.82 (5), p.33L-36L
  • Description: Thrombin generation is a key event in the pathophysiology of coronary syndromes and provides the rationale for treatment with anticoagulants. Unlike standard heparin, low-molecular-weight heparin (LMWH) has little effect on activated partial thromboplastin time. LMWH treatment has been monitored by measurement of anti-Factor Xa activity, but this may not accurately reflect the anticoagulant action because LMWHs also inhibit Factor II. The Heptest is a clotting assay that is sensitive to both anti-Xa and anti-IIa activity, as well as inhibition of the extrinsic pathway by LMWH-stimulated release of tissue factor pathway inhibitor. The plasma thrombin neutralization assay has also been used to measure LMWH and to detect low concentrations to which chromogenic assays are insensitive. In the clinical setting, monitoring the anti-Xa activity in patients treated with LMWH after acute deep vein thrombosis offered no advantages over a standard weight-adjusted dose. Moreover, in acute coronary syndromes there is no increase in major hemorrhage rates with weight-adjusted LMWH. Monitoring of LMWH concentrations may be advisable in the presence of comorbid conditions carrying an increased risk of hemorrhage, such as renal disease, advanced age, severe over- or underweight, or a history of previous bleeding episodes.
  • Publisher: United States: Elsevier Inc
  • Language: English
  • Identifier: ISSN: 0002-9149
    EISSN: 1879-1913
    DOI: 10.1016/S0002-9149(98)00111-8
    PMID: 9737479
    CODEN: AJCDAG
  • Source: MEDLINE
    Alma/SFX Local Collection
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