Skip to main content

Heparin and Low Molecular Weight Heparin in Thrombosis, Cancer, and Inflammatory Diseases

  • Protocol
Anticoagulants, Antiplatelets, and Thrombolytics

Part of the book series: Methods In Molecular Medicineā„¢ ((MIMM,volume 93))

  • 509 Accesses

Abstract

Despite the research and development efforts in newer anticoagulants, unfractionated heparin (UFH) and low molecular weight heparin (LMWH) will continue to play a pivotal role in the management of thrombotic disorders. Although bleeding and heparin-induced thrombocytopenia (HIT) represent major side effects of this drug, it has remained the anticoagulant of choice for the prophylaxis and treatment of arterial and venous thrombotic disorders, surgical anticoagulation, and interventional usage. It is the understanding of the structure of heparin that led to the development of LMWHs, synthetic hepari-nomimetics, antithrombin (AT), and anti-Xa agents.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Protocol
USD 49.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Weitz, J. I. (1997) Low-molecular-weight heparin. N. Engl. J. Med. 337, 688ā€“698.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  2. Mousa, S. A. and Fareed, J. W. (2001) Advances in anticoagulant, antithrombotic and thrombolytic drugs. Exp. Opin. Invest. Drugs 10(1), 157ā€“162.

    ArticleĀ  CASĀ  Google ScholarĀ 

  3. Fegan, C. D. (1998) Tinzaparin as an antithrombotic: an overview. Hosp. Med. 149, 1285ā€“1288.

    Google ScholarĀ 

  4. Aguilar, D. and Goldhaber, S. Z. (1999) Clinical uses of low molecular weight heparin. Chest 115(5), 1418ā€“1423.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  5. Linhardt, R. J. and Gunay, N. S. (1999) Production and chemical processing of low molecular weight heparins. Semin. Thromb. Hemost. 25(3), 5ā€“16.

    PubMedĀ  CASĀ  Google ScholarĀ 

  6. Mousa, S. A. (2000) Comparative efficacy among different low molecular weight heparin (LMWHs) & drug interaction: implications in the management of vascular disorders. Thromb. Haemostasis 26(l)(Suppl. 1), 39ā€“46. This study provides a comparative total anticoagulant efficacy among different LMWH showing dependency on the molecular weight and degree of sulfation.

    ArticleĀ  CASĀ  Google ScholarĀ 

  7. Hull, R. D., Raskob, G. E., Pineo, G. F., Green, D., Towbridge, A. A., Elliott, C. G, et al. (1992) Subcutaneous low-molecular weight heparin compared with continuous intravenous heparin in the treatment of proximal-vein thrombosis. N. Engl. J. Med. 326, 975ā€“982. This is a key double-blind clinical trial comparing the efficacy and safety of LMWH to UFH in-patients with VTE.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  8. Simonneau, G., Sors, H., Charbonnier, B., Page, Y., Laaban, J.-P., Bosson, J.-L., et al. (1997) A comparison of low-molecular-weight heparin with unfractionated heparin for acute pulmonary embolism. N. Engl. J. Med. 337, 663ā€“669.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  9. Hull, R. D., Raskob, G E., Pineo, G F., Rosenbloom, D., Evans, W., Mallory, T., et al. (1993) A comparison of subcutaneous low-molecular weight heparin with warfarin sodium for prophylaxis against deep-vein thrombosis after hip or knee implantation. N. Engl. J. Med. 329, 1370ā€“1376.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  10. Leizorovicz, A., Picolet, H., Peyrieux, J. C, Boissel, J. P., and the HBPM research group. (1991) Prevention of perioperative deep vein thrombosis in general surgery: a multicenter double blind study comparing two doses of logiparin and standard heparin. Br. J. Surg. 78, 412ā€“416.

    ArticleĀ  Google ScholarĀ 

  11. Ryan, K. E., Lane, D. A., Flynn, A., Shepperd, J., Ireland, H. A., and Curtis, J. R. (1991) Dose finding study of a low molecular weight heparin, tinzaparin, in haemodialysis. Thromb. Haemostasis 66(3), 277ā€“282.

    CASĀ  Google ScholarĀ 

  12. Pedersen, P. C, Ƙstergaard, P. B., Hedner, U., Bergqvist, D., and MƤtzsch, T. (1991) Pharmacokinetics of low molecular weight heparin, logiparin, after intravenous and subcutaneous administration to healthy volunteers. Thromb. Res. 61, 477ā€“487.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  13. MƤtzsch, T., Bergqvist, D., Hedner, U., and Ƙstergaard, P. B. (1987) Effects of an enzymatically depolymerized heparin as compared with conventional heparin in healthy volunteers. Thromb. Haemostasis 57(1), 97ā€“101.

    Google ScholarĀ 

  14. Mousa, S. A., Bozarth, J., Hainer, J., et al. (2001) Pharmacodynamic of tinzaparin following 175 IU/Kg SC administration in healthy volunteers on plasma TFPI. Thromb. Haemostasis P2299.

    Google ScholarĀ 

  15. Emmanuele, R. M. and Fareed, J. (1987) The effect of molecular weight on the bioavailability of heparin. Thromb. Res. 48, 591ā€“596.

    ArticleĀ  Google ScholarĀ 

  16. Brieger, D. and Dawes, J. (1997) Production method affects the pharmacokinetic and ex vivo biological properties of low molecular weight heparins. Thromb. Haemostasis 77(2), 317ā€“322.

    CASĀ  Google ScholarĀ 

  17. Mousa, S. A., Bozarth, J., Larnkjaer, A., and Johanson, K. (2000) Vascular effects of heparin molecular weight fractions and LMWH on the release of TFPI from human endothelial cells. Blood 16(11), 59, 3928.

    Google ScholarĀ 

  18. Kaiser, B., Hoppensteadt, D., and Fareed, J. (2000) Tissue factor pathway inhibitor for cardiovascular disorders. Emerging Drugs 5(1), 73ā€“87.

    ArticleĀ  CASĀ  Google ScholarĀ 

  19. Verstraete, M. (1990) Pharmacotherapeutic aspects of unfractionated and low molecular weight heparins. Drugs 40, 498ā€“530.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  20. Lindblad, B. (1988) Prophylaxis of postoperative thromboembolism with low dose heparin alone or in combination with dihydroergotamine. A review. Acta Chir. Scand. Suppl. 543, 31ā€“42.

    CASĀ  Google ScholarĀ 

  21. Hull, R., Delmore, T, Carter, C, Hirsh, J., Genton, E., Gent, M., et al. (1982) Adjusted subcutaneous heparin versus warfarin sodium in the long-term treatment of venous thrombosis. N. Engl. J. Med. 306, 189ā€“194.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  22. Hull, R. D., Raskob, G E., Hirsh, J., Jay, R. M., Leclerc, J. R., Geerts, W. H., et al. (1986) Continuous intravenous heparin compared with intermittent subcutaneous heparin in the initial treatment of proximal-vein thrombosis. N. Engl. J. Med. 315, 1109ā€“1114.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  23. Cruickshank, M. K., Levine, M. N., Hirsh, J., Roberts, R., and Siguenza, M. (1991) A standard heparin nomogram for the management of heparin therapy [see comments]. Arch. Intern. Med. 151, 333ā€“337.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  24. Hull, R. D., Raskob, G. E., Rosenbloom, D., Lemaire, J., Pineo, G. F, Baylis, B., et al. (1992) Optimal therapeutic level of heparin therapy in patients with venous thrombosis. Arch. Intern. Med. 152, 1589ā€“1595.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  25. Goldhaber, S. Z. (1996) Thrombolytic therapy for venous thromboembolism, in Disorders of Thrombosis (Hull, R. and Pineo, G. F., eds.), W.B. Saunders Co, pp. 321ā€“328.

    Google ScholarĀ 

  26. Gueret, P., Dubourg, O., Ferrier, A., Farcot, J. C, Rigaud, M., and Bourdarias, J. P. (1986) Effects of full-dose heparin anticoagulation on the development of left ventricular thrombosis in acute transmural myocardial infarction. J. Am. Coll. Cardiol. 8, 419ā€“426.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  27. Neri Serneri, G. G, Gensini, G. F, Poggesi, L., Trotta, F, Modesti, P. A., Boddi, M., et al. (1990) Effect of heparin, aspirin, or alteplase in reduction of myocardial ischaemia in refractory unstable angina (published erratum appears in Lancet 1990 Apr 7;335[8693]:868). Lancet 335, 615ā€“618.

    Google ScholarĀ 

  28. Bounameaux, H., Verhaeghe, R., and Verstraete, M. (1986) Thromboembolism and antithrombotic therapy in peripheral arterial disease. J. Am. Coll. Cardiol. 8, 98Bā€“103B.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  29. Matzsch, T., Bergqvist, D., Hedner, U., Nilsson, B., and Ostergaard, P. (1986) Heparin-induced osteoporosis in rats. Thromb. Haemostasis 56, 293ā€“294.

    CASĀ  Google ScholarĀ 

  30. Salzman, E. W., Rosenberg, R. D., Smith, M. H., Lindon, J. N., and Favreau, L. (1980) Effect of heparin and heparin fractions on platelet aggregation. J. Clin. Invest. 65, 64ā€“73.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  31. Friedel, H. A. and Balfour, J. A. (1994) Tinzaparin. A review of its pharmacology and clinical potential in the prevention and treatment of thromboembolic disorders. Drugs 48, 638ā€“660.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  32. Padilla, A., Gray, E., Pepper, D. S., and Barrowcliffe, T. W. (1992) Inhibition of thrombin generation by heparin and low molecular weight (LMW) heparins in the absence and presence of platelet factor 4 (PF4). Br. J. Haematol. 82, 406ā€“413.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  33. Fareed, J., Jeske, W., Hoppensteadt, D., Clarizio, R., and Walenga, J. M. (1998) Low-molecular-weight heparins: pharmacological profile and product differentiation. Am. J. Cardiol. 82, 3Lā€“10L.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  34. Boneu, B., Caranobe, C, Cadroy, Y., Dol, F., Gabaig, A. M., Dupouy, D., et al. (1988) Pharmacokinetic studies of standard unfractionated heparin, and low molecular weight heparins in the rabbit. Semin. Thromb. Hemost. 14, 18ā€“27.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  35. Sutor, A. H., Massicotte, P., Leaker, M., Andrew, M. (1997) Heparin therapy in pediatric patients. Semin. Thromb. Hemost. 23, 303ā€“319.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  36. Fareedman, M. D. (1996) Low molecular weight heparins: an emerging new class of glycosaminoglycan antithrombotic. J. Clin. Pharmacol. 31, 298ā€“306. Circulation 93, 2212ā€“2245.

    Google ScholarĀ 

  37. Fareed, J., Walenga, J. M., Hoppensteadt, D., Huan, X., and Nonn, R. (1989) Biochemical and pharmacological in-equivalence of low molecular weight heparins. Ann. NY Acad. Sci. 556, 333ā€“353.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  38. Lindahl, A. K., Abildgaard, U., and Stokke, G. (1990) Release of extrinsic pathway inhibitor after heparin injection: increased response in cancer patients. Thromb. Res. 59, 651ā€“656.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  39. Larnkjaer, A., Ostergaard, P. B., and Flodgaard, H. J. (1994) Binding of low molecular weight heparin (Tinzaparin sodium) to bovine endothelial cells in vitro. Thromb. Res. 75, 185ā€“194.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

  40. Ostergaard, P., Nordfang, O., Petersen, L. C., Valentin, S., and Kristensen, H. (1993) Is tissue factor pathway inhibitor involved in the antithrombotic effect of heparins? Biochemical considerations. Haemostasis 23 (Suppl. 1), 107ā€“111.

    PubMedĀ  Google ScholarĀ 

  41. Hull, R. D., Raskob, G E., Rosenbloom, D., Pineo, G., Lerner, R. G, Gafni, A., et al. (1997) Treatment of proximal vein thrombosis with subcutaneous low-molecular-weight heparin vs. intravenous heparin. Arch. Intern. Med. 157, 289ā€“294.

    ArticleĀ  PubMedĀ  CASĀ  Google ScholarĀ 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

Ā© 2004 Humana Press Inc.

About this protocol

Cite this protocol

Mousa, S.A. (2004). Heparin and Low Molecular Weight Heparin in Thrombosis, Cancer, and Inflammatory Diseases. In: Mousa, S.A. (eds) Anticoagulants, Antiplatelets, and Thrombolytics. Methods In Molecular Medicineā„¢, vol 93. Springer, Totowa, NJ. https://doi.org/10.1385/1-59259-658-4:35

Download citation

  • DOI: https://doi.org/10.1385/1-59259-658-4:35

  • Publisher Name: Springer, Totowa, NJ

  • Print ISBN: 978-1-58829-083-0

  • Online ISBN: 978-1-59259-658-4

  • eBook Packages: Springer Protocols

Publish with us

Policies and ethics