Heparins reduce the number of heart attacks after acute coronary syndromes

Clinical question: 
How effective are heparins in the treatment of patients with acute coronary syndromes (ACS)?
Bottom line: 
Compared to placebo, heparins reduce the number of heart attacks (NNT* 33) but cause more minor bleeding (NNH* 17) after ACS. The risks of mortality, revascularisation, recurrent angina, major bleeding and thrombocytopenia were similar in both groups. *NNT = number needed to treat to benefit one individual. *NNH = number needed to treat to cause harm in one individual.
Parenteral unfractionated heparin (UFH) or low molecular weight heparin (LMWH) was given in addition to standard therapy with aspirin.
Acute coronary syndromes include unstable angina and non-ST segment myocardial infarction. The use of UFH and LMWH heparin were evaluated in these trials, and were given within 24 to 72 hours of the onset of symptoms for a 2 to 8 day period.
Review CD#: 
July, 2008
Authored by: 
Brian R McAvoy