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Review
. 2008;4(2):305-13.
doi: 10.2147/vhrm.s1154.

New anticoagulant strategies in ST elevation myocardial infarction: trials and clinical implications

Conor J McCann  1 , Ian B A Menown
Affiliations
Review

New anticoagulant strategies in ST elevation myocardial infarction: trials and clinical implications

Conor J McCann et al. Vasc Health Risk Manag. 2008.

Abstract

New data have re-established the importance of anticoagulation of patients with ST segment elevation myocardial infarction (STEMI), both as an adjuvant to reperfusion therapy or in patients ineligible for reperfusion. Recent randomized trials have found newer agents to be superior to conventional unfractionated heparin. This article summarizes current understanding of the underlying pathophysiology of STEMI and provides a comprehensive review of emerging trial data for low molecular weight heparins, anti-factor Xa agents and direct thrombin inhibitors in this setting.

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Figures

Figure 1
Figure 1
Interaction of anti-thrombotic agents with coagulation cascade. UFH-antithrombin III complex has approximately equal inhibitory effects on factor Xa and IIa. LMWH-antithrombin III complex has greater relative specificity for factor Xa. Pentasaccharide-antithrombin III complex acts only on factor Xa. Abbreviations: UFH, unfractionated heparin; LMWH, low molecular weight heparin; DTI, direct thrombin inhibitors.
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