The Drug Approach To Anti-Clotting -- Dr. Fuster
Patients benefit from improved clotting drugs
Jun 21 (Reuters Health) - Newer versions of the anti- clotting drug heparin can improve treatment of individuals with blood vessel disease, according to the American Heart Association (AHA).
Low molecular weight heparin (LMWH) should be used in patients with acute heart symptoms such as heart disease-related chest pain, according to new guidelines on heparin published in the June 19th issue of Circulation: Journal of the American Heart Association.
The newer preparations can be given by injection into muscles, rather than intravenously, allowing patients to leave the hospital sooner and administer the drugs at home. Also, levels of the newer drugs do not fluctuate in the blood so doctors do not have to take frequent blood samples from patients, Dr. Valentin Fuster, former president of the AHA and director of the Cardiovascular Institute at the Mount Sinai School of Medicine in New York City, told Reuters Health.
"It is certainly as good, if not better, than (older preparations of) heparin," Fuster said.
He added that clinical studies are underway to investigate whether LMWH is effective for patients suffering a heart attack.
LMWH molecules are about a third of the size of regular heparin molecules. Heparin has been used for years to break apart clots that can lodge inside blood vessels and block blood flow. This condition, known as venous thromboembolism, is responsible for about 300,000 hospitalizations in the US each year.
While LMWH preparations have been found to be as effective as older versions, they are more expensive, Fuster and colleagues note. However, avoiding IVs spares patients from hospitalization and cuts costs.
The guidelines also note that patients who take aspirin may need lower doses of heparin, since full doses of the drug can increase the risk of bleeding in these patients.
The new guidelines update the last set of recommendations published in 1994.
SOURCE: Circulation 2001;103:2995-3019.
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