Advantage of Low-Molecular-Weight Heparin.

Aspirin plus heparin is a standard therapy for unstable angina. However, low-molecular-weight heparin offers advantages over conventional unfractionated heparin, including a more predictable anticoagulant effect, no need for monitoring of anticoagulation, resistance to inhibition by activated platelets, and a lower incidence of heparin-induced thrombocytopenia. Investigators from 176 centers in 10 countries compared subcutaneous enoxaparin (low-molecular-weight heparin) with intravenous unfractionated heparin in patients with unstable angina or non-Q-wave myocardial infarction.

This double-blind trial randomized 3,171 patients with chest pain lasting at least 10 minutes and evidence of ischemic heart disease to 1 mg of subcutaneous enoxapari…