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Low-Molecular-Weight Heparin in Acute Coronary Syndromes

机译：急性冠状动脉综合征的低分子量肝素

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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 intracoro-nary 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 antithrom-bin. 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.
机译：急性冠状动脉综合征（ACS）可以根据具有明显的ST段升高的存在或不存在分为两种不同的条件。随后的血栓形成，冠状动脉菌斑破裂通常是ACS的发展。已经开发了许多抗血栓形成疗法，以抑制血栓形成顺序过程中的关键步骤。凝血酶产生在创建核内血栓形成中至关重要。在治疗剂量的情况下，在接受非ST段升高的ACS的ACS患者中，在治疗剂量的患者中，死亡和心肌梗塞的风险降低了约50％。低分子量肝素（LMWH）主要针对因子Xa（以及较小程度的凝血酶）靶向与抗凝血纤维蛋白的抑制。许多精心设计的大型随机对照试验表明，LMWH至少具有可比性的疗效和安全性，可与未分流的肝素相提并论，但是它们的出色实践优势使它们成为了非ST段升高AC的ACS治疗的主要疗法。最近，在一项大型随机试验中，评估了LMWH在ST升高的ACs治疗中的作用。

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