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Fondaparinux (Arixtra), a synthetic factor Xa inhibitor, has outperformed the low-molecular-weight heparin enoxaparin in preventing venous thromboembolism after orthopedic surgery (Journal Watch Cardiology Aug 9 2002). In two new manufacturer-funded, multinational, randomized controlled trials, researchers tested fondaparinux in patients with coronary thrombosis.
In the OASIS-5 trial, 20,078 patients (mean age, 67) with unstable angina or non–ST-segment-elevation MI (UA/NSTEMI) were randomly assigned to receive single-dose fondaparinux (2.5 mg daily) or enoxaparin (1 mg/kg twice daily). Mean treatment duration was 6 days. At 9 days, incidence of the primary outcome — death, MI, or refractory ischemia — was similar with fondaparinux (5.8%) an…