|2004 STEMI Guideline Recommendation||2007 STEMI Focused Update Recommendation||Comments|
|It is reasonable that STEMI patients who are not undergoing reperfusion therapy and who do not have a contraindication to anticoagulation be treated with IV or subcutaneous UFH or with subcutaneous LMWH for at least 48 hours. In patients whose clinical condition necessitates prolonged bedrest and/or minimized activity, it is reasonable that treatment be continued until the patient is ambulatory. (Level of Evidence: C)||1. It is reasonable for patients with STEMI who do not undergo reperfusion therapy to be treated with anticoagulant therapy (non-UFH regimen) for the duration of the index hospitalization, up to 8 days. (Level of Evidence: B) Convenient strategies that can be used include those with LMWH (Level of Evidence: C) or fondaparinux (Level of Evidence: B) using the same dosing regimens as for patients who receive fibrinolytic therapy. See Section 126.96.36.199.8.1.||Modified recommendation (changed LOE and text)|
IV indicates intravenous; LMWH, low-molecular-weight heparin; LOE, level of evidence; STEMI, ST-elevation myocardial infarction; and UFH, unfractionated heparin.