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A number of the studies reviewed by Ramanath and Eagle involved diabetes patients, which present unique clinical challenges for the practitioner in prescribing effective and safe drug treatments. Some of the other studies also involved the use of statin drugs in combination with aspirin and Lovenox (heparin) as a method of preventative care, but the degree to which this impacted the results was also unremarked-upon. Finally, the question of non-drug treatment and recommendations for study participants to improve their health with diet and exercise was not noted in any of the studies: whether lifestyle alterations were controlled in the data is unclear, and the degree to which one group of patients may have altered their lifestyles through diet and exercise in conjunction with drug treatments was not noted. In terms of the comparison between aspirin and heparin: "among the antiplatelet therapies, aspirin, clopidogrel, and glycoprotein IIb/IIIa inhibitors demonstrate significant efficacy in reducing morbidity and mortality. Among the anticoagulants, unfractionated heparin and...
Bivalirudin has recently showed significant efficacy in decreasing cardiovascular events and mortality, but with potentially less risk of bleeding than heparin." Thus aspirin, beta-blockers, blood pressure lowering medications, and cholesterol lowering medications in combination were deemed to be the most vital elements of treating heart disease, although heparin did show some benefits as well and was not contraindicated.
Reference
Ramanath, V.S. & K.A. Eagle. (2007). Evidence-based medical therapy of patients with acute coronary syndromes. American Journal of Cardiovascular Drugs, 7(2):95-116.
Appendix: Search history
("aspirin"[MeSH Terms] or "aspirin"[All Fields]) and ("enoxaparin"[MeSH Terms] or "enoxaparin"[All Fields] or "lovenox"[All Fields]) and ("coronary disease"[MeSH Terms] or ("coronary"[All Fields] and "disease"[All Fields]) or "coronary disease"[All Fields])
Reference
Ramanath, V.S. & K.A. Eagle. (2007). Evidence-based medical therapy of patients with acute coronary syndromes. American Journal of Cardiovascular Drugs, 7(2):95-116.
Appendix: Search history
("aspirin"[MeSH Terms] or "aspirin"[All Fields]) and ("enoxaparin"[MeSH Terms] or "enoxaparin"[All Fields] or "lovenox"[All Fields]) and ("coronary disease"[MeSH Terms] or ("coronary"[All Fields] and "disease"[All Fields]) or "coronary disease"[All Fields])
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