A comparison of clinical outcomes between fondaparinux versus enoxaparin after primary percutaneous coronary intervention in patients with acute myocardial infarction:a multicenter,prospective real-world study
Guo Yanqing
Wang Jingping
Wang Rijun
Gu Chengqi
Yang Youdong
Fan Jiamao
Deng Junping
Guang Bin
Tan Chen
Wu Huipeng
Yue Long
Li Li
Wang Zhixin
An Jian
Abstract：Objective The objective of this study was to compare the risk of death and bleeding in patients with acute myocardial infarction(AMI)who underwent primary percutaneous coronary intervention(PPCI)after the operation of anticoagulation with fondaparinux and enoxaparin.Methods This is a multicenter,prospective,real-world study.A total of 715 patients with AMI treated with PPCI were selected from 8 hospitals in China from August 2019 to December 2021.According to the difference in postoperative anticoagulant drugs,patients were divided into the enoxaparin group(40～60 mg/d)and the fondaparinux group(2.5 mg/d),both of which were given subcutaneous injections for≤8 days.Patients were followed up for up to 180 days.The primary endpoint was death and cardiovascular and cerebrovascular adverse events,and the secondary endpoint was bleeding.Results A total of 715 patients were enrolled in this study,including 380 patients in the fondaparinux group and 335 patients in the enoxaparin group.Patients in the enoxaparin group had a lower age,a higher proportion of males,a higher weight,and a higher proportion of smokers and thrombus aspiration than those in the fondaparinux group(P＜0.05).The incidence of 180day bleeding was significantly lower in the fondaparinux group than in the enoxaparin group(17.4％vs.26.0％,P=0.005).After adjusting for age,sex,body weight,smoking,and thrombus aspiration using Cox proportional risk model,the risk of death was 69％lower in the fondaparinux group than in the enoxaparin group(HR=0.31;95％CI:0.16～0.63,P=0.001).Smoking,hypertension,diabetes,hyperlipidemia,thrombus aspiration,multiple stent implantation and old age were the risk factors for death,while the use of fondaparinux was the protective factor(HR=0.28;95％CI:0.12～0.65,P=0.003).Conclusion Among AMI patients receiving PPCI treatment,the incidence of bleeding in the fondaparinux group was significantly lower than that in the enoxaparin group 180 days after surgery,and the fondaparinux can reduce the risk of death within 180 days.
Keywords：Acute myocardial infarctionFondaparinuxEnoxaparinPrimary percutaneous coronary intervention
Publication Date：2024-09-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1065-1069 )