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By Losing (Molecular) Weight, A Clot-Dissolving Drug May Be In Better Shape To,,Help People Avoid A Repeat Heart Attack

DALLAS, July 28 -- In the future, people who have had mild heart attacks or suffer from chest pain may be able to inject themselves with a drug at home to prevent a heart attack or episodes of chest pain, say scientists.

In a study and editorial in today's Circulation: Journal of the American Heart Association, researchers say that enoxaparin -- a slimmed-down form of the commonly used clot-dissolving drug heparin -- could help stifle a clot-forming protein that enters the bloodstream after the heart is damaged.

The release of clot-inducing proteins into the bloodstream continues months after chest pain or mild heart attacks. Researchers say people affected could one day fight back with a regular therapy of at-home enoxaparin injections. "It seems logical to not only provide effective anti-clotting therapy during the initial episode of chest pain or just after the heart attack, but to also use that therapy in the months following that event," says the editorial's lead author Elliott Antman, M.D., director, Samuel A. Levine Cardiac Unit, Brigham and Women's Hospital in Boston. "In theory, this new research might allow physicians to prescribe relatively unsupervised long-term self-administration of anti-clotting therapy, sort of an insulin-like injection for coronary artery disease."

By using enoxaparin, researchers were able to control von Willebrand factor, a "reactant" protein released into the bloodstream when blood vessels are inflamed or when a person has a heart attack or chest pain. The scientists found enoxaparin to be superior to heparin in controlling von Willebrand factor. When released into the bloodstream, von Willebrand factor plays the role of traffic cop. It directs platelets -- disk-shaped blood particles that help form clots -- to the damaged area of blood vessels, leading to a particle pile-up that can form blood clots. By suppressing von Willebrand factor, potential clots can be avoided.

Scientists studied which of the "react
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Contact: Brian Henry
brianh@heart.org
214-706-1135
American Heart Association
27-Jul-1998


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