Heparin management in acute myocardial infarction (AMI).


Journal Article

Antithrombotic agents have been shown to be beneficial in the setting of acute coronary syndromes, and as an adjunct to thrombolysis for acute myocardial infarction (AMI). The optimal type and dosing of antithrombotic drug, however, remains elusive. Heparin, the agent most commonly used, has several limitations, the most important of which may be its inability to inhibit clot-bound thrombin. Newer, direct thrombin inhibitors (such as hirudin) provide potent and predictable thrombin inhibition and are able to inhibit clot-bound thrombin. Both heparin and hirudin can carry a substantial risk of haemorrhage, however, and thrombin activity is likely to rebound after discontinuation of either agent. Further, the relationships of antithrombotic/thrombolytic dosing, measures of anticoagulation (such as APTT), and clinical outcomes are not always clear. Nonetheless, from the data available from large, randomised trials, intravenous heparin should remain a standard adjunct to thrombolytic therapy for AMI.

Full Text

Duke Authors

Cited Authors

  • Granger, CB

Published Date

  • August 1998

Published In

Volume / Issue

  • 28 / 4

Start / End Page

  • 541 - 547

PubMed ID

  • 9777136

Pubmed Central ID

  • 9777136

International Standard Serial Number (ISSN)

  • 0004-8291

Digital Object Identifier (DOI)

  • 10.1111/j.1445-5994.1998.tb02107.x


  • eng

Conference Location

  • Australia