International Digest

Low-molecular-weight heparin in unstable coronary artery disease

Canadian Medical Association Journal 1996; 155: 909

Source: Fragmin during Instability in Coronary Artery Disease (FRISC) Study Group. Low-molecular-weight heparin during instability in coronary artery disease. Lancet 1996; 347: 561-8.

Researchers in Sweden randomly assigned 1506 patients with unstable coronary artery disease (CAD) to receive (along with acetylsalicylic acid and antianginal drugs) subcutaneous low-molecular-weight heparin (dalteparin; 120 IU/kg subcutaneously twice a day for 6 days, then 7500 IU for the next 35 to 45 days) or placebo injections, to determine whether dalteparin is protective against new cardiac events. During the first 6 days the rate of death and new myocardial infarction was significantly lower in the treatment group than in the control group, as was the need for intravenous heparin therapy and revascularization. Event rates were still reduced in the dalteparin group after 40 days, although this benefit was most pronounced in nonsmokers. The researchers concluded that treatment with dalteparin and acetylsalicylic acid for at least 6 days should be considered for patients with unstable CAD.

| CMAJ October 1, 1996 (vol 155, no 7) |