Fondaparinux in Percutaneous Coronary Intervention for the Treatment of Acute Coronary Syndrome

ABSTRACTBackgroundFondaparinux is an agent that has a well-established safety and efficacy profile in the treatment of non-ST segment elevation acute coronary syndromes. When used alone, however, it is associated with a higher incidence of thrombotic complications during invasive coronary procedures, requiring the supplementation of an anti-IIa agent. This study aimed to evaluate the efficacy and safety of percutaneous coronary intervention (PCI) in patients with non-ST segment elevation acute coronary syndromes that were previously treated with fondaparinux.MethodsThis was a prospective, controlled registry, enrolling 127 consecutive patients submitted to an early invasive stratification during treatment with fondaparinux with the supplementation of intravenous unfractionated heparin at a dose of 85 U/kg at the time of PCI.ResultsThe composite primary endpoint rate, including death, acute myocardial infarction, stroke, stent thrombosis, or emergency myocardial revascularisation was 3.2%. The cumulative incidence of major bleeding and vascular complications was 3.2%. There were no cases of guide catheter thrombosis or abrupt vessel closure.ConclusionsPCI in patients with acute coronary syndromes receiving fondaparinux was associated with a low rate of major adverse cardiovascular ischaemic events and severe haemorrhagic complications. Supplementation with unfractionated heparin during the invasive procedures eliminated the risk of catheter-related thrombosis