Low-molecular-weight heparins for the treatment of acute coronary syndromes.

Low-molecular-weight heparins (LMWHs) possess several advantages over unfractionated heparin (UFH) for the treatment of acute coronary syndromes (ACSs). Already a class I indication for the treatment of unstable angina/non-ST elevation myocardial infarction (UA/NSTEMI), LMWHs also show promise in the setting of ST elevation myocardial infarction (STEMI) and percutaneous coronary intervention (PCI). Moreover, a growing body of evidence has demonstrated equivalent safety of LMWH with concomitant use of glycoprotein IIb/IIIa inhibitors. Larger clinical studies are needed to confirm the safety and efficacy of LMWH as an antithrombin for the treatment across the spectrum of ACS.