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Comparison between Fondaparinux and Low-Molecular-Weight Heparin in Patients with Acute Coronary Syndrome: A Meta-Analysis.
- Source :
- Cardiology; Feb2016, Vol. 133 Issue 3, p163-172, 10p, 1 Diagram, 9 Charts
- Publication Year :
- 2016
-
Abstract
- Objective: A number of studies have evaluated the efficacy and safety of fondaparinux versus low-molecular-weight heparin (LMWH) in patients with acute coronary syndrome (ACS), but the findings were not consistent across these studies. Methods: Electronic databases and article references were searched for studies that assessed fondaparinux versus LMWH in ACS patients. Results: Six studies met the inclusion criteria. There was a lower risk of major adverse cardiac events (MACE) with fondaparinux-based regimens both in randomized controlled trials (RCT; risk ratio, RR: 0.91, p = 0.04) and observational studies (RR: 0.85, p < 0.0001). Mortality decreased in fondaparinux-treated patients in RCT (RR: 0.84, p = 0.02), but not in observational studies (RR: 1.44, p = 0.64). For the analysis of myocardial infarction (MI), recurrent ischemia and stroke, none of the studies showed significant results. In addition, fondaparinux lowered the risk of major bleeding in RCT (RR: 0.62, p < 0.0001) and observational studies (RR: 0.65, p < 0.0001). The net clinical outcome also favored fondaparinux over LMWH in RCT (RR: 0.82, p < 0.0001) and observational studies (RR: 0.84, p < 0.0001). Conclusions: Among ACS patients, a fondaparinux-based regimen presented advantages regarding MACE and major bleeding, and a net clinical benefit compared with LMWH, although the benefit is minimal regarding MACE. For death, MI, recurrent ischemia and stroke, fondaparinux has not shown significant benefits. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]
- Subjects :
- ANTICOAGULANTS
HEPARIN
ACUTE coronary syndrome
META-analysis
MYOCARDIAL infarction
Subjects
Details
- Language :
- English
- ISSN :
- 00086312
- Volume :
- 133
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 112962597
- Full Text :
- https://doi.org/10.1159/000441442