Please use this identifier to cite or link to this item:
Title: Comparison of fondaparinux and enoxaparin in acute coronary syndromes
Author: The OASIS-5 committee
Esplugas Oliveras, Enrique
Keywords: Amigdalitis
Anticoagulants (Medicina)
Ús terapèutic
Infart de miocardi
Anticoagulants (Medicine)
Therapeutic use
Myocardial infarction
Issue Date: 6-Apr-2006
Publisher: Massachusetts Medical Society
Abstract: Background: the combined use of anticoagulants, antiplatelet agents, and invasive coronary procedures reduces ischemic coronary events but also increases bleeding in patients with acute coronary syndromes. We therefore assessed whether fondaparinux would preserve the anti-ischemic benefits of enoxaparin while reducing bleeding. Methods: we randomly assigned 20,078 patients with acute coronary syndromes to receive either fondaparinux (2.5 mg daily) or enoxaparin (1 mg per kilogram of body weight twice daily) for a mean of six days and evaluated death, myocardial infarction, or refractory ischemia at nine days (the primary outcome); major bleeding; and their combination. Patients were followed for up to six months. Results: the number of patients with primary-outcome events was similar in the two groups (579 with fondaparinux [5.8 percent] vs. 573 with enoxaparin [5.7 percent]; hazard ratio in the fondaparinux group, 1.01; 95 percent confidence interval, 0.90 to 1.13), satisfying the noninferiority criteria. The number of events meeting this combined outcome showed a nonsignificant trend toward a lower value in the fondaparinux group at 30 days (805 vs. 864, P=0.13) and at the end of the study (1222 vs. 1308, P=0.06). The rate of major bleeding at nine days was markedly lower with fondaparinux than with enoxaparin (217 events [2.2 percent] vs. 412 events [4.1 percent]; hazard ratio, 0.52; P<0.001). The composite of the primary outcome and major bleeding at nine days favored fondaparinux (737 events [7.3 percent] vs. 905 events [9.0 percent]; hazard ratio, 0.81; P<0.001). Fondaparinux was associated with a significantly reduced number of deaths at 30 days (295 vs. 352, P=0.02) and at 180 days (574 vs. 638, P=0.05). Conclusions: fondaparinux is similar to enoxaparin in reducing the risk of ischemic events at nine days, but it substantially reduces major bleeding and improves long term mortality and morbidity.
Note: Reproducció del document publicat a:
It is part of: New England Journal of Medicine, 2006, vol. 354, num. 14, p. 1464-1476
Related resource:
ISSN: 0028-4793
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)

Files in This Item:
File Description SizeFormat 
575754.pdf232.42 kBAdobe PDFView/Open

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.