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Peer-reviewedCC BY 4.0Frontiers in Pharmacology

Low-molecular-weight heparins in atrial fibrillation: clinical scenarios, limitations, and future perspectives

  • Sabina Mędrek1,2
  • Magdalena Zaborowska-Szmit3
  • Sebastian Szmit1,4
4 affiliations
  1. 1Department of Cardio-Oncology, Centre of Postgraduate Medical Education
  2. 2Department of Cardiology and Cardio-Oncology Unit, Subcarpathian Oncological Center
  3. 3Department of Lung Cancer and Thoracic Tumours, Maria Skłodowska-Curie National Research Institute of Oncology
  4. 4Cardio-Oncology Unit, Maria Skłodowska-Curie National Research Institute of Oncology
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Abstract

Introduction: Atrial fibrillation (AF) is associated with a significantly increased risk of thromboembolic complications, including ischaemic stroke. Despite the dominant role of oral anticoagulants, low-molecular-weight heparins (LMWHs) are still used in selected clinical scenarios.

Aim: The aim of this review was to summarise the current clinical role of LMWHs in atrial fibrillation, with particular emphasis on available evidence, practical limitations and selected complex clinical scenarios.

Methods: A review based on the analysis of available clinical trials, guidelines, and pharmacological data.

Results: Low-molecular-weight heparins are used primarily for bridging therapy and in situations where oral anticoagulation is temporarily contraindicated or not feasible. However, robust evidence supporting the long-term use of LMWHs for stroke prevention in atrial fibrillation remains limited.

Conclusion: Low-molecular-weight heparins should not be considered standard chronic therapy for atrial fibrillation. Further studies are needed to better define optimal anticoagulation strategies in patients with atrial fibrillation, particularly in complex clinical settings such as active cancer and thrombocytopenia.

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Cite

BibTeXRIS
BibTeX
@article{medrek2026lowmolecularweight,
  title = {{Low-molecular-weight heparins in atrial fibrillation: clinical scenarios, limitations, and future perspectives}},
  author = {Sabina Mędrek and Magdalena Zaborowska-Szmit and Sebastian Szmit},
  journal = {Frontiers in Pharmacology},
  year = {2026},
  month = oct,
  doi = {10.3389/fphar.2026.1853400},
  url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1853400/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Low-molecular-weight heparins in atrial fibrillation: clinical scenarios, limitations, and future perspectives
AU  - Sabina Mędrek
AU  - Magdalena Zaborowska-Szmit
AU  - Sebastian Szmit
PY  - 2026
DA  - 2026/10/07
JO  - Frontiers in Pharmacology
DO  - 10.3389/fphar.2026.1853400
UR  - https://www.frontiersin.org/articles/10.3389/fphar.2026.1853400/full
AB  - Introduction: Atrial fibrillation (AF) is associated with a significantly increased risk of thromboembolic complications, including ischaemic stroke. Despite the dominant role of oral anticoagulants, low-molecular-weight heparins (LMWHs) are still used in selected clinical scenarios.  Aim: The aim of this review was to summarise the current clinical role of LMWHs in atrial fibrillation, with particular emphasis on available evidence, practical limitations and selected complex clinical scenarios.  Methods: A review based on the analysis of available clinical trials, guidelines, and pharmacological data.  Results: Low-molecular-weight heparins are used primarily for bridging therapy and in situations where oral anticoagulation is temporarily contraindicated or not feasible. However, robust evidence supporting the long-term use of LMWHs for stroke prevention in atrial fibrillation remains limited.  Conclusion: Low-molecular-weight heparins should not be considered standard chronic therapy for atrial fibrillation. Further studies are needed to better define optimal anticoagulation strategies in patients with atrial fibrillation, particularly in complex clinical settings such as active cancer and thrombocytopenia.
SN  - 1663-9812
ER  -