Bleeding events related to Fondaparinux versus Enoxaparin in non-ST elevation acute coronary syndrome patients

DOI: 10.5083/ejcm20424884.182 , Cite or Link Using DOI
Creating a Digital Object Identifier Link

A digital object identifier (DOI) can be used to cite and link to electronic documents. A DOI is guaranteed never to change, so you can use it to link permanently to electronic documents.

To find a document using a DOI

  1. Copy the DOI of the document you want to open.
    The correct format for citing a DOI is as follows: doi:10.1016/S0140-6736(08)61345-8
  2. Open the following DOI site in your browser:
  3. Enter the entire DOI citation in the text box provided, and then click Go.
    The document that matches the DOI citation will display in your browser window.

The DOI scheme is administered by the International DOI Foundation. Many of the world's leading publishers have come together to build a DOI-based document linking scheme known as CrossRef.

Jaime Aboal, Pablo Loma-Osorio, Josep Iglesies, Maria Nuñez, Daniel Bosch, Aleix Fort, Eulalia Badosa , Hasan Kassem, Coloma Tiron, Ramon Brugada


Introduction: Fondaparinux compared to enoxaparin reduced bleeding rates and mortality in clinical trials of patients presenting with acute coronary syndromes. Nevertheless, its benefits in real world scenarios are less studied.

Objectives: The aim of the present study was to compare both treatments in terms of bleeding events in patients admitted with non-ST elevation acute coronary syndrome (NSTE-ACS).

Methods: A single-centre retrospective registry (January 2010 to December 2019) of patients admitted with NSTE-ACS was conducted. We compared the bleeding rates of the two groups of patients treated with either fondaparinux or enoxaparin. We created a multivariate model to identify the independent predictors of bleeding events and we analysed its association with the predicted bleeding risk using CRUSADE risk score.

Results: Total 2,752 patients admitted with NSTE-ACS were registered. Of those, 1,544 patients (56.1%) were treated with fondaparinux and 1,208 patients (43.9%) with enoxaparin. Compared to enoxaparin, fondaparinux group showed a significant reduction in the rate of bleeding BARC ≥2 (9.2% vs.5.6%, respectively, p <0.001). There were no differences between the two groups in terms of mortality (2.8% vs. 2.8%, p=0.52). In the multivariant analysis, use of fondaparinux (hazard ratio: 0.57, 95% CI [0.37- 0.86], p=0.008) was independent predictor factor related with bleeding events. This finding was mainly observed in the high bleeding risk group assessed by CRUSADE score.

Conclusion: In our registry, fondaparinux significantly reduced bleeding events compared to enoxaparin in NSTE-ACS without differences in mortality, particularly in high bleeding risk patients