Document Detail

Fondaparinux: an overview.
MedLine Citation:
PMID:  19505272     Owner:  NLM     Status:  MEDLINE    
Fondaparinux is a synthetic pentasaccharide belonging to a new group of anticoagulants that inhibit thrombin formation by inhibiting Factor Xa, which is located at the crossing of both the intrinsic and extrinsic pathways. It has a favorable pharmacokinetic profile, and its effect is predictable and the drug does not need platelet monitoring. Current evidence suggest that fondaparinux is as effective as, if not more than, enoxaparin in the prevention of venous thromboembolism in the postoperative period. It has also been found to have similar effectiveness to enoxaparin and unfractionated heparin in the treatment of venous and pulmonary embolism, respectively. In the field of cardiology, studies have demonstrated that in the setting of acute coronary syndromes, treatment with fondaparinux is not inferior to enoxaparin in preventing major cardiac outcomes, but it is associated with lower risk of bleeding complications, irrespective of the use of percutaneous coronary intervention. During percutaneous coronary intervention, there is a slightly increased risk of catheter thrombosis, which is removed when used along with unfractionated heparin. However, in patients with ST-elevation myocardial infarction, the benefit has been shown in those either receiving thrombolysis or not undergoing any revascularization, but not in subjects undergoing primary percutaneous coronary intervention where unfractionated heparin is still preferred.
Sunil K Nadar; Deepak Goyal; Eduard Shantsila; Pritwish Banerjee; Gregory Y H Lip
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Expert review of cardiovascular therapy     Volume:  7     ISSN:  1744-8344     ISO Abbreviation:  Expert Rev Cardiovasc Ther     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-09     Completed Date:  2009-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101182328     Medline TA:  Expert Rev Cardiovasc Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  577-85     Citation Subset:  IM    
Specialist Registrar, Department of Cardiology, University Hospital of Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, UK.
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MeSH Terms
Acute Coronary Syndrome / drug therapy
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  methods
Anticoagulants / pharmacokinetics,  pharmacology,  therapeutic use*
Drug Interactions
Enoxaparin / adverse effects,  therapeutic use
Factor Xa / antagonists & inhibitors*
Polysaccharides / pharmacokinetics,  pharmacology,  therapeutic use*
Venous Thromboembolism / prevention & control
Reg. No./Substance:
0/Anticoagulants; 0/Enoxaparin; 0/Polysaccharides; 0/fondaparinux; EC Xa

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