After almost two decades of intensive research, low-molecular-weightheparins have established their niche as an important classof antithrombotic compounds. The demonstration that these compoundsare safe and effective for the prevention and treatment of venousthromboembolism has led to the licensing of several of themin Europe and North America. In addition, danaparoid sodium,which is a mixture of dermatan sulfate, heparan sulfate, andchondroitin sulfate, is often used for the treatment of heparin-inducedthrombocytopenia.1 Low-molecular-weight heparins have replacedunfractionated heparin in many parts of Europe but are onlynow finding their place in North America. Their use is . . . [Full Text of this Article]
Mechanisms of Action of Low-Molecular-Weight Heparins
Pharmacokinetics of Low-Molecular-Weight Heparins
Clinical Studies
Prophylaxis against Thromboembolism
General Surgery
Orthopedic Surgery of the Lower Limb
Total Hip Replacement
Total Knee Replacement
Surgery for Hip Fracture
Acute Spinal Cord Injury
Multiple Trauma
Medical Conditions
Patency of Femoropopliteal Bypass Grafts
Restenosis after Angioplasty
Treatment of Thrombosis
Venous Thrombosis
Unstable Angina
Ischemic Stroke
Remaining Questions
Preoperative or Postoperative Dosing with Low-Molecular-Weight Heparins
Once-Daily versus Twice-Daily Dosing
Risk of Heparin-Induced Thrombocytopenia
Neutralization of Low-Molecular-Weight Heparins with Protamine Sulfate
Safety of Low-Molecular-Weight Heparins in Pregnancy
Risk of Heparin-Induced Osteoporosis
Comparability of Various Preparations of Low-Molecular-Weight Heparin
Cost Effectiveness
Summary
Source Information
From the Hamilton Civic Hospitals Research Centre and McMaster University, Hamilton, Ont., Canada.
Address reprint requests to Dr. Weitz at the Hamilton Civic Hospitals Research Centre, 711 Concession St., Hamilton, ON L8V 1C3, Canada.
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