The Pharmaceutical Journal
Vol 276 No 7392 p312
18 March 2006

This article
Reprint   Photocopy

  Acrobat Reader

News summary

Fondaparinux may help some myocardial infarction patients

Fondaparinux, a factor Xa inhibitor, is effective in reducing mortality and reinfarction in patients with acute ST-segment elevation myocardial infarction (STEMI), according to a study presented at the American College of Cardiology annual scientific session in Atlanta, Georgia, and published online in JAMA this week (14 March).

Investigators randomised 12,092 patients with STEMI to receive fondaparinux 2.5mg once daily or a control treatment. Control patients received either unfractionated heparin for up to 48 hours followed by placebo for up to eight days, or placebo for eight days if unfractionated heparin was not indicated.

Mortality or reinfarction at 30 days was reduced in the fondaparinux group compared with the control group (hazard ratio 0.86, 95 per cent confidence interval 0.77–0.96; P=0.008). This benefit was seen at nine days (0.83, 0.73–0.94; P=0.003) and at final six- or nine-month follow-up (0.88, 0.79–0.97; P=0.008).

However, no benefit with fondaparinux was seen for patients undergoing primary percutaneous coronary intervention (PCI). In fact, the authors acknowledge that higher rates of coronary complications occurred in fondaparinux subjects during PCI procedures.