What medication is preferred over unfractionated heparin following fibrinolysis?

After fibrinolytic therapy, enoxaparin is preferred over unfractionated heparin due to its pharmacokinetic properties and safety profile. Enoxaparin is a low molecular weight heparin (LMWH) that offers several advantages, such as more predictable anticoagulant effects, a longer half-life, and reduced risk of heparin-induced thrombocytopenia.

The use of enoxaparin allows for better management of anticoagulation in patients who have undergone fibrinolysis, as it maintains effective antithrombotic activity while minimizing the potential complications associated with unfractionated heparin. The established guidelines recommend administering enoxaparin consistently after primary PCI and fibrinolysis because it enhances patient outcomes including an improvement in mortality rates.

Other medications, such as fondaparinux, while beneficial in certain situations, are not typically preferred in the immediate post-fibrinolysis context due to specific pharmacological interactions and limitations in certain scenarios, such as higher bleeding risk in combination with fibrinolytics. Aspirin provides antiplatelet benefits but does not serve as an alternative to anticoagulation, and β-blockers are crucial for managing heart rate and myocardial oxygen demand but do not have a direct role in