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Low-molecular-weight heparin (LMWH) is a class of anticoagulant medications. [1] They are used in the prevention of blood clots and, in the treatment of venous thromboembolism ( deep vein thrombosis and pulmonary embolism ), and the treatment of myocardial infarction .
Unfractionated heparin (UFH) as a pharmaceutical is heparin that has not been fractionated to sequester the fraction of molecules with low molecular weight. In contrast, low-molecular-weight heparin (LMWH) has undergone fractionation to make its pharmacodynamics more predictable. Often either UFH or LMWH can be used; in some situations one or ...
Antithrombin concentrates have been used, though with risk of bleeding at large doses of unfractionated heparin. Low molecular weight heparin at full weight based dosing is effective; however, measurements of peak anti-Xa levels may not reflect anticoagulant effect.
A 2021 review found that low molecular weight heparin (LMWH) was superior to unfractionated heparin in the initial treatment of venous thromboembolism for people with cancer. [3] There are medication-based interventions and non-medication-based interventions. [4]
Heparin is the most widely used intravenous clinical anticoagulant worldwide. [82] Heparin is a naturally occurring glycosaminoglycan. There are three major categories of heparin: unfractionated heparin (UFH), low molecular weight heparin (LMWH), and ultra-low-molecular weight heparin (ULMWH). [83]
Up to 8% of patients receiving heparin are at risk to develop HIT antibodies, but only 1–5% on heparin will progress to develop HIT with thrombocytopenia and subsequently one-third of them may develop arterial or venous thrombosis. [1] After vascular surgery, 34% of patients receiving heparin developed HIT antibodies without clinical symptoms ...
Antithrombin (AT) is a small glycoprotein that inactivates several enzymes of the coagulation system. It is a 464-amino-acid protein produced by the liver.It contains three disulfide bonds and a total of four possible glycosylation sites. α-Antithrombin is the dominant form of antithrombin found in blood plasma and has an oligosaccharide occupying each of its four glycosylation sites.
The affinity of unfractionated heparin and the various LMWHs for Factor Xa varies considerably. The efficacy of heparin-based anticoagulants increases as selectivity for Factor Xa increases. LMWH shows increased inactivation of Factor Xa compared to unfractionated heparin, and fondaparinux, an agent based on the critical pentasacharide sequence ...