Low-molecular-weight heparin: prophylaxis and treatment of venous thromboembolism

Abstract

Intravenous heparin followed by warfarin has been the classical anticoagulant therapy of acute venous thromboembolism for the last 30 years. Furthermore, low-dose unfractionated heparin given two to three times daily has been the most popular form of prophylaxis for venous thrombosis. In recent years, a number of low-molecular-weight heparins have become available for clinical trials. These agents have many advantages over unfractionated heparin and are now being used widely internationally for the prevention and treatment of venous thromboembolism. Indeed, low-molecular-weight heparin will undoubtedly replace intravenous unfractionated heparin not only in the treatment of venous thromboembolism, but in other conditions where heparin therapy is indicated. Whether or not the low-molecular-weight heparins can decrease or eliminate some of the complications of unfractionated heparin will depend on the outcome of future clinical trials.