Efficacy and safety of fondaparinux sodium prolonged treatment in patients with acute myocardial infarction underwent percutaneous coronary intervention / 中国医师进修杂志

ABSTRACT

Objective To observe the efficacy and safety of fondaparinux sodium prolonged treatment in patients with acute myocardial infarction underwent primary percutaneous coronary intervention (PCI).Methods A total of 121 patients with acute ST segment elevation myocardial infarction (STEMI) underwent primary PCI from February 2011 to April 2012 were divided into three groups by random digits table method:40 patients in fondaparinux sodium general treatment group (A group),41 patients in fondaparinux sodium prolonged treatment group (B group) and 40 patients in enoxaparin group (C group).The basic treatment was similar among three groups.The patients in A group were given fondaparinux sodium 2.5 mg/d for 5-7 d,and the averaged time was 6.02 d.The patients in B group were given fondaparinux sodium 2.5 mg/d for 10-15 d,and the averaged time was 12.61 d.The patients in C group were given enoxaparin 5000 U/12 h for 5-7 d,and the averaged time was 6.21 d.Main outcome indexes including re-myocardial ischemia,new-myocardial infarction,death and bleeding were observed within 15 d after treatment.Results The incidence of death,re-myocardial ischemia,new-myocardial infarction and overall cardiovascular events in B group [4.9％(2/41),0,0,4.9％(2/41)] were significantly lower than those in A group [25.0％(10/40),12.5％(5/40),10.0％(4/40),47.5％(19/40)] and C group [27.5％(11/40),15.0％(6/40),12.5％ (5/40),55.0％ (22/40)],and there were significant differences among three groups (P ＜ 0.05or ＜0.01).The incidence of mild bleeding,severe bleeding and overall bleeding in C group [32.5％(13/40),15.0％ (6/40),47.5％ (19/40)] were significantly higher than those in A group [10.0％ (4/40),2.5％(1/40),12.5％(5/40)] and B group [14.6％(6/41),2.4％(1/41),17.1％(7/41)],and there were significant differences among three groups (P ＜ 0.05 or ＜ 0.01).Conclusions Fondaparinux sodium prolonged anticoagulation treatment can significantly reduce overall cardiovascular events in patients with STEMI underwent primary PCI,and does not increase bleeding.It is safe and effective.