Comparison of two treatment durations (6 days and 14 days) of a low molecular weight heparin with a 6-day treatment of unfractionated heparin in the initial management of unstable angina or non-Q wave myocardial infarction: FRAX.I.S. (FRAxiparine in Ischaemic Syndrome)

Charbonnier, B; Fotiadis, Ioannis; Keltai, Mátyás; Leizorovicz, Alain; Marzilli, Mario; Masiá, Rafel; Moccetti, Tiziano; Renard, Marc; Sadowski, Zygmunt; Seabra-Gomes, R; Špác, Jiří; Meer, Jan van der; Varshavsky, Sergei; Vincent, R

doi:10.1053/euhj.1999.1879

Cited by 220 publications

(9 citation statements)

References 21 publications

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“…In addition, low molecular weight heparins can be injected subcutaneously and administered without monitoring of the aPTT. Several low molecular weight heparins, including enoxaparin sodium, dalteparin sodium, nadroparin calcium, ardeparin, danaparoid, and tinzaparin, are available 17–22 . Beyond the specific antithrombin agents discussed above, phase II and phase III trials are ongoing on several experimental inhibitors of thrombin—factor Xa, factor IXa, and the factor VIIa/tissue factor complex—as well experimental enhancers of the protein C anticoagulant pathway 1,23 …”

Section: Discussionmentioning

confidence: 99%

Serious Adverse Vascular Events Associated With Perioperative Interruption of Antiplatelet and Anticoagulant Therapy

Alam

Goldberg

2002

Dermatol Surg

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Section: Discussionmentioning

confidence: 99%

Serious Adverse Vascular Events Associated With Perioperative Interruption of Antiplatelet and Anticoagulant Therapy

Alam

Goldberg

2002

Dermatol Surg

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“…The Fraxiparine in Ischemic Syndrome study [25] randomized 3,468 patients with ACS with non-ST-segment elevation (characteristic anginal pain within 48 h and electrocardiographical signs compatible with the clinical diagnosis) to receive one of three therapies: (1) standard intravenous UFH for 6 days; (2) nadroparin anti-Xa 86 IU/kg intravenous bolus followed by nadroparin anti-Xa 86 IU/kg subcutaneously twice daily for 6 days, or (3) nadroparin anti-Xa 86 IU/kg intravenous bolus followed by nadroparin anti-Xa 86 IU/kg subcutaneously twice daily for 14 days. All patients were treated with aspirin.…”

Section: Randomized Controlled Trials Comparing Lmwh With Ufhmentioning

confidence: 99%

Low-Molecular-Weight Heparin in Acute Coronary Syndromes

O’Donnell¹,

Turpie²

2004

Heart Drug

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Acute coronary syndrome (ACS) may be divided into two distinct conditions on the basis of the electrographical presence or absence of significant ST-segment elevation. Coronary arterial plaque rupture with subsequent thrombus formation is usually responsible for the development of ACS. A number of antithrombotic therapies have been developed to inhibit key steps in the sequential process of thrombus formation. Thrombin generation is of critical importance in the creation of intracoronary thrombosis. Heparins, in therapeutic doses, reduce the risk of death and myocardial infarction by about 50% in aspirin-treated patients presenting with ACS with non-ST-segment elevation. Low-molecular-weight heparin (LMWH) primarily targets the inhibition of factor Xa (and to a lesser extent thrombin) by binding with antithrombin. A number of well-designed, large randomized controlled trials have shown that LMWHs have at least comparable efficacy and safety to unfractionated heparin, but their superior practical advantages have made them a mainstay therapy in the treatment of ACS with non-ST-segment elevation. More recently, the role of LMWH in the treatment of ACS with ST elevation has been evaluated in a large randomized trial.

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“…To this end, several randomized studies have investigated the LMWHs nadroparin, dalteparin (Fragmin) and enoxaparin as alternatives to UFH in the management of UA/ NQMI [45, 46, 47, 48]. In a single-blind investigation, 219 patients were randomly assigned, within 24 h of an acute ischemic episode, to three groups for treatment.…”

Section: Role Of Lmwhs In the Management Of Acute Coronary Syndromesmentioning

confidence: 99%

“…(FRAXiparine in Ischaemic Syndromes) trial was performed to investigate the effect of an extended treatment period with nadroparin in patients with UA or NQMI [45]. A total of 3,468 patients were randomly assigned to three treatment arms.…”

Section: Role Of Lmwhs In the Management Of Acute Coronary Syndromesmentioning

confidence: 99%

“…In a single-blind investigation, 219 patients were randomly assigned, within 24 h of an acute ischemic episode, to three groups for treatment. One group was treated with aspirin (200 mg/day), another one with aspirin plus UFH (5,000-IU bolus followed by a 400 IU/kg/day continuous infusion titrated by activated partial thromboplastin time to twice the normal value), and the third one with aspirin plus nadroparin (214 Units Institute Choay/kg subcutaneously twice daily) [45]. Antithrombotic treatment was continued for 5–7 days or until the development of a primary end point (recurrent angina, myocardial infarction, urgent revascularization, major bleeding or death).…”

Section: Role Of Lmwhs In the Management Of Acute Coronary Syndromesmentioning

confidence: 99%

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Update on the Management of Acute Coronary Syndromes

Cohen¹

2000

Cardiology

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At present there is debate as to whether an invasive or a conservative strategy should form the basis of an optimal management strategy for unstable angina/non-Q wave myocardial infarction (UA/NQMI). However, these approaches are complementary, not necessarily mutually exclusive. On the basis of current evidence, all patients should receive optimized medical therapy, with surgical interventions targeted at high-risk patients, to improve both clinical outcomes and cost effectiveness. While standard antithrombotic combinations have improved short-term outcomes, they do not fully eliminate the risk of recurrent ischemic episodes. The recent introduction of direct thrombin inhibitors, platelet fibrinogen receptor antagonists and low-molecular-weight heparins (LMWHs) has offered an opportunity to develop more aggressive antithrombotic regimens. Enoxaparin, an LMWH, has demonstrated improved efficacy compared with standard heparin in both the acute and chronic phases of UA/NQMI, without an increase in major complications caused by bleeding. Further studies are justified to investigate the potential of combined antithrombotic regimens containing enoxaparin as an alternative to heparin in conservative strategies and as adjuncts to interventional procedures. Recommendations for the management of UA/NQMI should be continually reviewed in response to the impact of novel treatment modalities.

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Comparison of two treatment durations (6 days and 14 days) of a low molecular weight heparin with a 6-day treatment of unfractionated heparin in the initial management of unstable angina or non-Q wave myocardial infarction: FRAX.I.S. (FRAxiparine in Ischaemic Syndrome)

Cited by 220 publications

References 21 publications

Serious Adverse Vascular Events Associated With Perioperative Interruption of Antiplatelet and Anticoagulant Therapy

Serious Adverse Vascular Events Associated With Perioperative Interruption of Antiplatelet and Anticoagulant Therapy

Low-Molecular-Weight Heparin in Acute Coronary Syndromes

Update on the Management of Acute Coronary Syndromes

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