Publicação: Fondaparinux em intervenção coronária percutânea no tratamento da síndrome coronária aguda
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Background: Fondaparinux is considered an agent with a well-established safety and efficacy profile in the treatment of non-ST segment elevation acute coronary syndromes, but when used alone, is associated to 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 previously treated with fondaparinux. Methods: Prospective, controlled registry enrolling 127 consecutive patients submitted to an early invasive stratification during treatment with fondaparinux, with supplementation of intravenous unfractionated heparin at a dose of 85 U/kg at the time of PCI. Results: The rate of the composite primary endpoint including death, acute myocardial infarction, stroke, stent thrombosis or emergency myocardial revascularization was 3.2%. The cumulative incidence of major bleeding and vascular complications was 3.2%. There were no cases of guidecatheter thrombosis or abrupt vessel closure. Conclusions: PCI in patients with acute coronary syndromes receiving fondaparinux is associated with a low rate of major adverse cardiovascular ischemic events and severe hemorrhagic complications. Supplementation of unfractionated heparin during the invasive procedures eliminates the risk of catheter-related thrombosis.
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Acute coronary syndrome, Angioplasty, Anticoagulants, Fondaparinux, Stents, fondaparinux, heparin, acute coronary syndrome, acute heart infarction, bleeding, catheter thrombosis, clinical trial, death, disease association, drug efficacy, drug safety, emergency care, heart muscle ischemia, human, major clinical study, non st segment elevation acute coronary syndrome, percutaneous coronary intervention, prospective study, revascularization, stent thrombosis, stroke, vascular disease
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Revista Brasileira de Cardiologia Invasiva, v. 20, n. 2, 2012.
