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July 12, 1993

Low-Molecular-Weight Heparins: Is Smaller Better?

Author Affiliations

Ball Memorial Hospital 2401 University Ave Muncie, IN 47303

Arch Intern Med. 1993;153(13):1525-1526. doi:10.1001/archinte.1993.00410130027003

HEARIN WAS first described in 1916 by McLean1 who was working in the laboratory of Dr William Howell. McLean was given the assignment to extract thromboplastin from various animal tissues. Ironically, rather than isolating procoagulant thromboplastin, he was successful in extracting an anticoagulant. Following his discovery, heparin was found to be an extremely effective anticoagulant in vitro and was first given to patients in the 1930s and early 1940s. Heparin quickly became established as the main initial form of anticoagulant therapy, and, with the introduction of dialysis, extracorporeal surgical procedures, as well as flushing of indwelling lines, heparin has a virtually ubiquitous presence in the hospital setting.

The standard preparations of heparin are extracts of either porcine mucosa or bovine lung. Heparin is a glycosaminoglycan that consists of alternating residues of D-glucosamine and either glucuronic acid or iduronic acid.2 The anticoagulant properties of heparin are dependent on a