FONDAPARINUX IN THE TREATMENT OF ACUTE CORONARY SYNDROME

Abstract

Fondaparinux is a parenteral selective factor-Xa inhibitor. The drug is successfully used in the treatment of acute coronary syndrome, and is characterized by the ideal profile of effectiveness and safety. In the case of ACS without ST-segment elevation, fondaparinux is the drug of choice regardless of the treatment strategy - early invasive or conservative. In the case of PCI, an anticoagulant with anti-IIa activity (either UFH or bivalirudin) should be administered immediately before the procedure. In patients with ACS with ST-segment elevation, fondaparinux is used as an anticoagulant accompaniment of thrombolysis (primarily, with streptokinase) or in patients not receiving reperfusion therapy. In the case of elective primary PCI in these patients, it is more appropriate to use UFH. For the treatment of ACS, fondaparinux is used at a dose of 2.5 mg/day and administered within 8 days, up until discharge (if it happens earlier) or a successful PCI. The greatest benefits from the use of fondaparin- ux should be expected in patients with a high risk for bleeding, including in patients with moderate renal failure with a decrease in creatinine clearance to 30-60 ml/min.

Keywords

• fondaparinux
• arixtra
• acute coronary syndrome
• myocardial infarction
• bleeding
• percutaneous coronary intervention
• thrombosis