Comparing Fondaparinux, Heparin for Lowering Bleeding Risk in NSTEMI
(HealthDay News) — In a new study, patients who received fondaparinux to treat non-ST-segment elevation myocardial infarction (NSTEMI) had a lower risk of major bleeding and death compared to patients who received low-molecular-weight heparin (LMWH). The findings were published in the February 17 issue of the Journal of the American Medical Association.
Karolina Szummer, MD, PhD, of the Karolinska Institute in Stockholm, and colleagues analyzed the medical records of 40,616 Swedish patients who had heart attacks classified as NSTEMIs between September 2006 and June 2010. In this study, 36.4% of Swedish patients received fondaparinux and 63.6% received LMWH.
The investigators found that fewer severe in-hospital bleeding events occurred in patients treated with fondaparinux – 1.1% compared with 1.8% for patients given LMWH. The fondaparinux patients also died less often during treatment in the hospital – 2.7% of all cases compared with 4% for the LMWH group. The differences in major bleeding events and death between the two treatments held steady at 30-day and six-month follow-ups. The rate of recurrent heart attack in the fondaparinux group was 9% vs. 9.5% in the LMWH group at 30 days, and 14.2% vs. 15.8% at six months. The rate of stroke was low in both groups.
These findings, drawn from a large Swedish health records database, confirm the results of a 2006 clinical trial that showed that fondaparinux could be used to safely and effectively treat these types of heart attacks, Szummer told HealthDay. She also pointed out that European and American cardiology guidelines already recommend fondaparinux for treating heart attacks, even though the U.S. Food and Drug Administration has not approved it for that use.
Several authors disclosed financial ties to pharmaceutical companies, including GlaxoSmithKline, which manufactures fondaparinux.