Management of acute coronary syndromes with fondaparinux

Figures & data

Figure 1 Mode of action of fondaparinux.

Table 1 Main pharmacological properties of fondaparinux

Source	Synthetic
Structure	Homogenic
Molecular weight	1728 Dalton
Target	Specific factor Xa
Protein binding in plasma	Thrombin only
Administration	Intravenous or subcutaneous
	Once daily
Time to peak concentrationn	2 hours
Plasma half life	17 hours
Bioavailibility	100%
Hepatic metabolism	No
Elimination	Unchanged in urine
Monitoring of coagulation parameters	No
Heparin-induced thrombocytopenia	No

Figure 2 Meta-analysis of fondaparinux versus enoxaparin in prevention of deep venous thrombosis prevention in randomized clinical trials. Compiled from data of Turpie et al (2002)

Abbreviations: DVT, deep vein thrombosis.

Figure 3 Incidence of worsening of TIMI flow grade in the infarct vessel between 90 minutes and day 5 in the PENTALYSE trial.

Abbreviations: TIMI, thrombolysis in myocardial infarction.

Figure 4 Incidence of the combined endpoint of death and myocardial infaction at different times points after randomization in the OASIS-6 trial.

Abbreviations: MI, myocardial infarction.

Table 2 Outcomes/complications at 30 days in patients undergoing PCI in the OASIS-6 trial

	PCI - UFH group (1898 patients)	PCI – fondaparinux group(1890 patients)	P value
Death or myocardial infarction	93	114	ns
Guiding catheter thrombosis	0	22	<0.001
Coronary complicationsa	225	270	0.04

a Coronary complications were: abrupt coronary artery closure, new angiographic thrombus, catheter thrombus, no reflow, dissection, perforation.

Abbreviations: PCI, percutaneous coronary intervention; UFH, unfractionated heparin.

Figure 5 Combined endpoint according to the randomization strata in the OASIS-6 study.

Abbreviations: MI, myocardial infarction; PCI, percutaneous coronary intervention.

Table 3 Major bleeding complications until day 9 in the OASIS-6 trial

	Placebo or UFH	Fondaparinux	P value
All cases	2.1%	1.8%	0.14
Stratum 1	2.0%	1.4%	0.07
Stratum 2	2.3%	2.1%	0.7
- No PCI	3.2%	2.2%	0.09
- PCI	1.7%	2.2%	0.27

Abbreviations: PCI, percutaneous coronary intervention; UFH, unfractionated heparin.

TurpieAGBauerKAErikssonBIFondaparinux vs enoxaparin for the prevention of venous thromboembolism in major orthopedic surgery: a meta-analysis of 4 randomized double-blind studiesArch Intern Med200216218334012196081

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