Prescrire Int. 1999 Jun;8(41):77-80.
(1) Enoxaparin and dalteparin are the only low-molecular-weight heparins so far approved for the treatment of unstable angina and non Q-wave myocardial infarction. (2) In two trials involving over 7,000 patients with unstable angina or non Q-wave myocardial infarction, the enoxaparin + aspirin combination was more effective than the unfractionated heparin + aspirin combination in reducing the risk of death, myocardial infarction or angina relapse. (3) In the same indication another trial showed no significant difference between the dalteparin + aspirin combination and the unfractionated heparin + aspirin combination on the basis of the same end point. (4) The dose must be calculated precisely according to bodyweight, as there is a severe risk of bleeding if the recommended dose is exceeded. (5) Continued enoxaparin therapy after clinical stabilisation has no supplementary benefit compared with aspirin alone.
(1) 依诺肝素和达肝素是目前仅有的被批准用于治疗不稳定型心绞痛和非Q波心肌梗死的低分子量肝素。(2) 在两项涉及7000多名不稳定型心绞痛或非Q波心肌梗死患者的试验中，依诺肝素+阿司匹林组合在降低死亡、心肌梗死或心绞痛复发风险方面比普通肝素+阿司匹林组合更有效。(3) 在相同适应证下，另一项试验表明，基于相同终点，达肝素+阿司匹林组合与普通肝素+阿司匹林组合之间无显著差异。(4) 剂量必须根据体重精确计算，因为如果超过推荐剂量，有严重出血风险。(5) 临床稳定后继续使用依诺肝素治疗与单独使用阿司匹林相比无额外益处。
