Low molecular weight heparin in comparison to unfractionated heparin for the management of unstable angina (UA). Update

Hender K
Record ID 32003000672
Authors' objectives:

This aim of this report was to update a previous report on the effectiveness of low molecular weight heparin in comparison to unfractionated heparin for the management of unstable angina.

Authors' recommendations: - Since the release of our previous report (Anderson, 1998) there have been two meta-analyses, one randomised controlled trial and 3 guidelines published comparing low molecular weight heparin (LMWH) with unfractionated heparin (UH) in the management of unstable angina. - The studies included the LMWHs enoxaparin, dalteparin, and nadroparin and assessed the following outcomes: death, myocardial infarction (MI), revascularization, recurrent angina and risk of bleeding. - Most studies found that LMWH resulted in lower rates of death, MI, recurrent angina and vascularization than UH. - One guideline recommends LMWH over UH whereas the other guidelines advise that either should be used. - The risk of minor but not major bleeding was greater in the LMWH group compared to UH groups. We are unable to reach conclusions regarding the effectiveness of different types of LMWHs, although they may vary. The studies were of variable quality with one meta-analysis, the RCT and one guideline being of particularly high quality.
Authors' methods: Review
Project Status: Completed
Year Published: 2000
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Australia
MeSH Terms
  • Angina, Unstable
  • Heparin
  • Heparin, Low-Molecular-Weight
Organisation Name: Centre for Clinical Effectiveness
Contact Address: Monash Institute of Health Services Research, Block E, Monash Medical Centre, Locked Bag 29, Clayton, Victoria 3168, Australia. Tel: +61 3 9594 7505; Fax: +61 3 9594 7552.
Contact Name: cce@med.monash.edu.au.
Contact Email: cce@med.monash.edu.au.
Copyright: Centre for Clinical Effectiveness (CCE)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.