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Antithrombin therapy, antiplatelet therapy and percutaneous coronary intervention: rationale and design of the SYNERGY trial

J.J. Ferguson*

Texas Heart Institute, Houston, Texas, USA

* Correspondence: James J. Ferguson, MD, Associate Director, Cardiology Research, Texas Heart Institute, St. Luke's Episcopal Hospital, 6720 Benner Avenue, Mail Code 1-191, Houston, TX 77030, USA

Abstract

Although low-molecular-weight heparins (LMWHs) have been shown to be equivalent or superior to unfractionated heparin for the management of patients with unstable angina (UA) or non-ST-elevation myocardial infarction (NSTEMI), a number of clinical issues remain. Among them are the safety of bringing patients to the catheterization laboratory and the use of glycoprotein (GP)Ilb/Illa antagonists. The Superior Yield of the New strategy of Enoxaparin, Revascularization and GlYcoprotein IIb/IIIa inhibitors (SYNERGY) trial is a randomized study comparing the safety and efficacy of unfractionated heparin and the LMWH enoxaparin in high-risk, invasively managed UA/NSTEMI patients who are likely to receive GPIIb/IIIa antagonists.

Key Words: Heparin • low-molecular-weight heparin • percutaneous atherectomy • platelet glycoprotein IIb/IIIa receptor antagonist/inhibitor • unstable angina


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