TITLE

Fondaparinux was not inferior to unfractionated heparin for symptomatic pulmonary embolism: COMMENTARY

AUTHOR(S)
Gould, Michael K.
PUB. DATE
May 2004
SOURCE
ACP Journal Club;May/Jun2004, Vol. 140 Issue 3, p68
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Fondaparinux is a synthetic pentasaccharide that exerts its anticoagulant effect by direct and specific inhibition of factor Xa. Unlike unfractionated heparin (UFH), it has a more predictable dose-response relation, does not require laboratory monitoring in most circumstances, and can be given as treatment for venous thromboembolism (VTE) once daily by subcutaneous injection. Another important advantage of fondaparinux is that there is little or no risk for immune-mediated thrombocytopenia. A disadvantage is its higher cost. Strengths of the study by investigators include large size, central randomization, very low dropout rate, and clear demonstration of noninferiority in preventing recurrent VTE events over 3 months. The open-label design raises the possibility that physicians may have been more likely to suspect recurrences in patients who received UFH or to ignore recurrences in patients assigned to fondaparinux.
ACCESSION #
13221838

 

Related Articles

  • Heparin-Induced Thrombocytopenia and Paradoxical Thromboembolism: Diagnostic and Therapeutic Dilemmas. Bick, Rodger L. // Clinical & Applied Thrombosis/Hemostasis;Jan1997, Vol. 3 Issue 1, p63 

    Highlights important points of a study on therapy for patients with heparin-induced thrombocytopenia (HIT) and paradoxical thromboembolism. Types of HIT; Physiological mechanism for HIT; Laboratory diagnostic tools for HIT; Therapeutic modalities for HIT.

  • Rates of clinically apparent heparin-induced thrombocytopenia for unfractionated heparin vs. low molecular weight heparin in non-surgical patients are low and similar. Locke, Charles F. S.; Dooley, John; Gerber, Jonathan // Thrombosis Journal;2005, Vol. 3, p4 

    With the growing use of low-molecular-weight heparins (LMWH) for the treatment and prevention of venous thromboembolism (VTE), it is important to provide an evidence-based comparison with unfractionated heparin (UFH) concerning rates of heparin-induced thrombocytopenia (HIT). Such comparisons...

  • Phlegmasia Cerulea Dolens and Its Association with Hypercoagulable States: Case Reports. Cohen, David J.; Briggs, Richard; Head, Harold D.; Acher, Charles W. // Angiology;May1989, Vol. 40 Issue 5, p498 

    Six patients who developed phlegmasia cerulea dollens are described. All patients had associated hypercoagulable states: heparin-induced thrombocytopenia (2 patients), congenital deficiency of protein C (1 patient), and antithrombin Ill deficiency (3 patients). Their clinical course and...

  • Bilateral Lower Extremity Gangrene Requiring Amputation Associated with Heparin-Induced Thrombocytopenia A Case Report. Dickinson, Brian P.; De Ugarte, Daniel A.; Reil, Todd D.; Beseth, Bryce D.; Lawrence, Peter F. // Vascular & Endovascular Surgery;Mar/Apr2006, Vol. 40 Issue 2, p161 

    Heparin use, both prophylactically and therapeutically, is prevalent among hospitalized patients. Patients on heparin may develop a thrombocytopenia that is self-limited. Fewer patients develop a heparin-induced thrombocytopenia that can cause severe bleeding and thrombosis owing to...

  • Heparin-induced thrombocytopenia: an update. Franchini, Massimo // Thrombosis Journal;2005, Vol. 3, p14 

    Heparin-induced thrombocytopenia (HIT) is the most important and most frequent drug-induced, immune-mediated type of thrombocytopenia. It is associated with significant morbidity and mortality if unrecognized. In this review, we briefly discuss the main features of heparin-induced...

  • The Incidence of Heparin-Induced Thrombocytopenia in Hospitalized Medical Patients Treated With Subcutaneous Unfractionated Heparin: A Prospective Cohort Study. Sobel, Michael // Perspectives in Vascular Surgery & Endovascular Therapy;Apr2004, Vol. 16 Issue 2, p147 

    The authors conducted a prospective cohort follow-up study in 598 medical patients to determine the incidence of heparin-induced thrombocytopenia or venous thrombotic events as a complication of intravenous unfractionated heparin. Patients were admitted to two medical wards and treated with...

  • Heparin-Induced Thrombocytopenia: A Case Report. Van Damme, H.; Darmas, P.; David, J.L.; Limet, R. // Angiology;Dec1990, Vol. 41 Issue 12, p1075 

    The authors report a case of heparin-induced thrombocytopenia, in whom massive pulmonary embolism occurred in spite of heparin anticoagulation. Successful pulmonary thrombectomy was carried out under cardiopulmonary bypass, with limitation of platelet clumping during bypass by aggregation...

  • Ask the Experts. Martchenke, Julie; Pate, Mary Frances D.; Cruz, Maria; Phromsivarak, Serena // Critical Care Nurse;Feb2004, Vol. 24 Issue 1, p66 

    Answers a question on the incidence of heparin-induced thrombocytopenia (HIT) in children. Types of HIT; Cardinal laboratory finding of early HIT; Signs and symptoms of HIT in children.

  • Heparin-Induced Thrombocytopenia: An Iceberg Rising. Arnold, Donald M.; Kelton, John G. // Mayo Clinic Proceedings;Aug2005, Vol. 80 Issue 8, p988 

    Focuses on a study related to heparin-induced thrombocytopenia (HIT). Ability to diagnose HIT in a routine clinical laboratory; Proposal of an iceberg model for HIT; Study of patients undergoing hemodialysis who had frequent exposures to heparin.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics