{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,11,19]],"date-time":"2023-11-19T19:40:08Z","timestamp":1700422808324},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T00:00:00Z","timestamp":1233619200000},"content-version":"vor","delay-in-days":2774,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2001,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Unstable angina and non\u2010ST\u2010segment elevation myocardial infarction (MI) are collectively referred to as unstable coronary artery disease (UCAD). They are conditions that share a common pathophysiology and represent frequently encountered, potentially life\u2010threatening clinical manifestations of advanced atherosclerosis. Therefore, treatment of UCAD is a major focus for practicing clinicians, and although pharmacologic agents have been developed that impact on patient outcome, recent data suggest that a further reduction in ischemic complications is possible. Acute\u2010phase treatment with aspirin is associated with a significant reduction in death and nonfatal MI in patients with UCAD. This benefit is enhanced by the addition of unfractionated heparin (UFH) to the treatment strategy; however, UFH requires careful monitoring and titration. in contrast, low\u2010molecular\u2010weight heparins (LMWHs), produced by chemical or enzymatic depolymerization of UFH, yield a predictable and consistent pharmacokinetic profile and anticoagulant response, making them an attractive treatment alternative to UFH in patients with UCAD. The optimal duration of treatment with LMWH is an important question influenced by the observation that reactivation of coagulation occurs following the early and abrupt discontinuation of heparin treatment. Early trials, such as FRISC and FRIC, demonstrated the benefit of acute therapy with dalteparin sodium; however, the results of extended treatment with dalteparin were inconclusive. The extended phase of these studies included relatively low\u2010risk patients, and a once\u2010daily, relatively low\u2010dose strategy was employed. The findings derived from the FRISC II trial, which used a twice\u2010daily dose of dalteparin, suggest a benefit for at least 60 days with extended treatment in high\u2010risk patients with UCAD. Although an early\u2010invasive treatment strategy is particularly beneficial, patients in whom early revascularization is not possible should be considered for extended treatment with dalteparin for up to 45 days, especially those awaiting percutaneous coronary intervention. Extended treatment with dalteparin therefore provides a protective \u201cbridge\u201d to enhance the outcome of patients with UCAD awaiting revascularization.<\/jats:p>","DOI":"10.1002\/clc.4960240715","type":"journal-article","created":{"date-parts":[[2009,2,3]],"date-time":"2009-02-03T23:07:28Z","timestamp":1233702448000},"page":"492-499","source":"Crossref","is-referenced-by-count":4,"title":["A critical review of clinical trials for low\u2010molecular\u2010weight heparin therapy in unstable coronary artery 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