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Communications to the Editor |

Low-Molecular-Weight Heparin for Unstable Angina FREE TO VIEW

Tsung O. Cheng, MD, FCCP
Author and Funding Information

The George Washington University Medical Center Washington, DC

Correspondence to: Tsung O. Cheng, MD, FCCP, Professor of Medicine, The George Washington University Medical Center, 2150 Pennsylvania Ave, NW, Washington, DC 20037



Chest. 1999;116(6):1833. doi:10.1378/chest.116.6.1833-a
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To the Editor:

In an excellent review article on the clinical use of low-molecular-weight heparin (LMWH), Aguilar and Goldhaber (May 1999)1discussed its use in patients with unstable angina and cited the Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-Wave Coronary Events (ESSENCE) study. For the sake of completeness, I would like to mention three additional studies that have been published on the use of LMWH in patients with unstable angina. They are the study by Gurfinkel et al,2the Fragmin during Instability in Coronary Artery Disease (FRISC) study,3and the Fragmin in Unstable Coronary Artery Disease (FRIC) study.4

These three studies all concluded that treatment with LMWH of patients with unstable angina is at least as effective as, and potentially more effective than with, unfractionated heparin. Therefore, in deciding the heparin of choice, it is no longer merely a matter of “weight watching.”56

References

Aguilar, D, Goldhaber, SZ (1999) Clinical uses of low-molecular-weight heparins.Chest115,1418-1423. [CrossRef]
 
Gurfinkel, EP, Manos, EJ, Mejaíl, RI, et al Low molecular weight heparin versus regular heparin or aspirin in the treatment of unstable angina and silent ischemia.J Am Coll Cardiol1995;26,313-318. [CrossRef]
 
Fragmin during Instability in Coronary Artery Disease (FRISC) Study Group. Low-molecular-weight heparin during instability in coronary artery disease. Lancet 1996; 347:561–568.
 
for the FRIC Investigators. Klein, W, Buchwald, A, Hillis, SE, et al Comparison of low-molecular-weight heparin with unfractionated heparin acutely and with placebo for 6 weeks in the management of unstable coronary artery disease: Fragmin in Unstable Coronary Artery Disease Study (FRIC).Circulation1997;96,61-68. [CrossRef]
 
Levi, M, Peters, RJG, Büller, HR Weight watching in cardiology: low molecular weight heparin for acute coronary syndromes.Cardiovasc Res1998;37,564-566. [CrossRef]
 
Cheng, TO Weight watching in heparin [letter]. Arch Intern Med. 1999;;159 ,.:1142. [CrossRef]
 

Figures

Tables

References

Aguilar, D, Goldhaber, SZ (1999) Clinical uses of low-molecular-weight heparins.Chest115,1418-1423. [CrossRef]
 
Gurfinkel, EP, Manos, EJ, Mejaíl, RI, et al Low molecular weight heparin versus regular heparin or aspirin in the treatment of unstable angina and silent ischemia.J Am Coll Cardiol1995;26,313-318. [CrossRef]
 
Fragmin during Instability in Coronary Artery Disease (FRISC) Study Group. Low-molecular-weight heparin during instability in coronary artery disease. Lancet 1996; 347:561–568.
 
for the FRIC Investigators. Klein, W, Buchwald, A, Hillis, SE, et al Comparison of low-molecular-weight heparin with unfractionated heparin acutely and with placebo for 6 weeks in the management of unstable coronary artery disease: Fragmin in Unstable Coronary Artery Disease Study (FRIC).Circulation1997;96,61-68. [CrossRef]
 
Levi, M, Peters, RJG, Büller, HR Weight watching in cardiology: low molecular weight heparin for acute coronary syndromes.Cardiovasc Res1998;37,564-566. [CrossRef]
 
Cheng, TO Weight watching in heparin [letter]. Arch Intern Med. 1999;;159 ,.:1142. [CrossRef]
 
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