Document Detail


Fondaparinux in acute coronary syndromes.
MedLine Citation:
PMID:  19929450     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Antithrombotic therapies form the cornerstone of management of acute coronary syndromes (ACS). An ideal antithrombotic agent should reduce ischemic complications while keeping bleeding events to a minimum. Heparins, both unfractionated and low molecular weight, reduce ischemic outcomes but also significantly increase the risk of major and minor bleeding. Moreover, they do not reduce mortality. Therefore, there is a need for newer agents that preserve the benefits of ischemia reduction while decreasing mortality and bleeding risk. Fondaparinux is a synthetic pentasaccharide which specifically targets factor Xa of the coagulation cascade. It has been effectively used in the prevention of and treatment of venous thromboembolic disease. Two large randomized controlled trials of fondaparinux compared to unfractionated and low molecular weight heparins, among patients with ACS have recently been completed. These studies have shown a significantly lower risk of bleeding with fondaparinux compared to heparins, with equivalent or greater reductions in ischemic outcomes. A small but definite increase in the risk of catheter-related thrombosis has been found among patients undergoing coronary interventions, which is ameliorated by the administration of unfractionated heparin. This review outlines the pharmacological properties of fondaparinux and critically examines the available clinical trial data for fondaparinux in ACS.
Authors:
Vivek Chaturvedi; Ganesan Karthikeyan
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert opinion on drug metabolism & toxicology     Volume:  5     ISSN:  1744-7607     ISO Abbreviation:  Expert Opin Drug Metab Toxicol     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-25     Completed Date:  2010-02-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101228422     Medline TA:  Expert Opin Drug Metab Toxicol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1615-23     Citation Subset:  IM    
Affiliation:
GB Pant Hospital, Department of Cardiology, New Delhi, India.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / drug therapy*
Fibrinolytic Agents / adverse effects,  pharmacology,  therapeutic use*
Humans
Polysaccharides / adverse effects,  pharmacology,  therapeutic use*
Randomized Controlled Trials as Topic
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Polysaccharides; 0/fondaparinux

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