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J Am Coll Cardiol, 2009; 54:468-476, doi:10.1016/j.jacc.2009.03.062
© 2009 by the American College of Cardiology Foundation
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Efficacy and Safety of Fondaparinux Versus Enoxaparin in Patients With Acute Coronary Syndromes Treated With Glycoprotein IIb/IIIa Inhibitors or Thienopyridines

Results From the OASIS 5 (Fifth Organization to Assess Strategies in Ischemic Syndromes) Trial

Sanjit S. Jolly, MD, MSc*,*, David P. Faxon, MD{dagger}, Keith A.A. Fox, MB, ChB{ddagger}, Rizwan Afzal, MSc*, William E. Boden, MD§, Petr Widimsky, MD||, P. Gabriel Steg, MD, Vicent Valentin, MD#, Andrez Budaj, MD**, Christopher B. Granger, MD{dagger}{dagger}, Campbell D. Joyner, MD{ddagger}{ddagger}, Susan Chrolavicius, BScN*, Salim Yusuf, DPhil* and Shamir R. Mehta, MD, MSc*

* Department of Medicine, Hamilton Health Sciences, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
{dagger} Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
{ddagger} Royal Infirmary and University of Edinburgh, Edinburgh, Scotland
§ Department of Cardiology, University of Buffalo School of Medicine, Buffalo General Hospital, Buffalo, New York
|| Charles University, Hospital Kralovske Vinohrady, Prague, Czech Republic
Département de Cardiologie, INSERM U-698, Université Paris 7, AP-HP, Paris, France
# Hospital Universitari Dr. Peset, Valencia, Spain
** Postgraduate Medical School, Department of Cardiology, Grochowski Hospital, Warsaw, Poland
{dagger}{dagger} Duke Clinical Research Institute, Duke University, Durham, North Carolina
{ddagger}{ddagger} Department of Medicine, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada


Figure 1
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Figure 1 Safety and Efficacy of Fondaparinux Versus Enoxaparin in GP IIb/IIIa and Thienopyridine Subgroups

Fondaparinux reduced major bleeding and improved net clinical outcome compared with enoxaparin irrespective of glycoprotein (GP) IIb/IIIa or thienopyridine use. CI = confidence interval; MI = myocardial infarction.

 

Figure 2
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Figure 2 Kaplan-Meier Event Curves for Major Bleeding and Net Clinical Outcome for GP IIb/IIIa and Thienopyridine Subgroups

Net clinical outcome (death, myocardial infarction, refractory ischemia, or major bleeding). GP = glycoprotein; HR = hazard ratio.

 

Figure 3
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Figure 3 In Those Undergoing PCI, the Efficacy and Safety of Fondaparinux Versus Enoxaparin in Those Treated With GP IIb/IIIa Inhibitors or Pre-Treated (≥6 h) With Thienopyridines or Both

In the PCI population, fondaparinux reduced major bleeding compared with enoxaparin regardless of GP IIb/IIIa or thienopyridine pre-treatment. PCI = percutaneous coronary intervention; other abbreviations as in Figure 1.

 




 
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