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Article: Advances in antithrombin therapy for ST-elevation myocardial infarction

TitleAdvances in antithrombin therapy for ST-elevation myocardial infarction
Authors
Issue Date2003
PublisherChinese Medical Association. The Journal's web site is located at http://www.cmj.org
Citation
Chinese Medical Journal, 2003, v. 116 n. 11, p. 1760-1763 How to Cite?
AbstractThrombin is a pivotal molecule in acute myocardial infarction (MI) because of its extensive procoagulant and prothrombotic actions. Antithrombin therapy is an important component of the pharmacotherapy for acute MI. The standard agent used in clinical practice, unfractionated heparin (UFH), is associated with the disadvantages of variable anticoagulant effect, inability to inhibit clot-bound thrombin, neutralization by platelet factor 4, and the propensity to cause thrombocytopenic complications. Novel thrombin inhibitors have been developed to overcome these disadvantages. Although possessing the property of inhibiting both fluid-phase and clot-bound thrombin, the direct thrombin inhibitor hirudin has been shown to give marginal benefits over UFH as adjunct to fibrinolysis in ST-elevation MI. Bivalirudin, another direct thrombin inhibitor, is able to reduce reinfarction in patients treated with streptokinase and is a new anticoagulant treatment option in this setting. The pharmacokinetic characteristics of better availability, longer half-life, and dose-independent clearance together with the ability of inhibiting both thrombin generation and activity make the low-molecular-weight heparins (LMWHs) an attractive alternative to UFH. The favorable benefit/risk profile of the LMWHs as adjunct to different generations of fibrinolytic agents is setting the stage for larger clinical trials to confirm their role as the antithrombin agent of choice for STEMI.
DescriptionReview
Persistent Identifierhttp://hdl.handle.net/10722/224714
ISSN
2015 Impact Factor: 0.957
2015 SCImago Journal Rankings: 0.428

 

DC FieldValueLanguage
dc.contributor.authorChen, WH-
dc.contributor.authorLau, CP-
dc.date.accessioned2016-04-13T03:16:51Z-
dc.date.available2016-04-13T03:16:51Z-
dc.date.issued2003-
dc.identifier.citationChinese Medical Journal, 2003, v. 116 n. 11, p. 1760-1763-
dc.identifier.issn0366-6999-
dc.identifier.urihttp://hdl.handle.net/10722/224714-
dc.descriptionReview-
dc.description.abstractThrombin is a pivotal molecule in acute myocardial infarction (MI) because of its extensive procoagulant and prothrombotic actions. Antithrombin therapy is an important component of the pharmacotherapy for acute MI. The standard agent used in clinical practice, unfractionated heparin (UFH), is associated with the disadvantages of variable anticoagulant effect, inability to inhibit clot-bound thrombin, neutralization by platelet factor 4, and the propensity to cause thrombocytopenic complications. Novel thrombin inhibitors have been developed to overcome these disadvantages. Although possessing the property of inhibiting both fluid-phase and clot-bound thrombin, the direct thrombin inhibitor hirudin has been shown to give marginal benefits over UFH as adjunct to fibrinolysis in ST-elevation MI. Bivalirudin, another direct thrombin inhibitor, is able to reduce reinfarction in patients treated with streptokinase and is a new anticoagulant treatment option in this setting. The pharmacokinetic characteristics of better availability, longer half-life, and dose-independent clearance together with the ability of inhibiting both thrombin generation and activity make the low-molecular-weight heparins (LMWHs) an attractive alternative to UFH. The favorable benefit/risk profile of the LMWHs as adjunct to different generations of fibrinolytic agents is setting the stage for larger clinical trials to confirm their role as the antithrombin agent of choice for STEMI.-
dc.languageeng-
dc.publisherChinese Medical Association. The Journal's web site is located at http://www.cmj.org-
dc.relation.ispartofChinese Medical Journal-
dc.subject.meshAnticoagulants - therapeutic use-
dc.subject.meshElectrocardiography-
dc.subject.meshHeparin, Low-Molecular-Weight - therapeutic use-
dc.subject.meshMyocardial Infarction - drug therapy - physiopathology-
dc.subject.meshThrombin - antagonists & inhibitors-
dc.titleAdvances in antithrombin therapy for ST-elevation myocardial infarction-
dc.typeArticle-
dc.identifier.emailChen, WH: whchen@hkucc.hku.hk-
dc.identifier.emailLau, CP: cplau@hku.hk-
dc.description.naturelink_to_OA_fulltext-
dc.identifier.pmid14642154-
dc.identifier.hkuros88172-
dc.identifier.volume116-
dc.identifier.issue11-
dc.identifier.spage1760-
dc.identifier.epage1763-
dc.publisher.placeChina-

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