fondaparinux and Coronary-Artery-Disease

Topics: Angioplasty, Balloon, Coronary; Anticoagulants; Coronary Artery Disease; Cyclic N-Oxides; Factor IXa; Fondaparinux; Heparin; Hirudins; Humans; Peptide Fragments; Polysaccharides; Pyridines; Recombinant Proteins

Multiple key cardiology trials have been presented or published over recent months, several with the potential to change clinical practice. In this article, we summarize and place in clinical context new trial findings regarding anticoagulation in the cardiac catheterization laboratory (enoxaparin, fondaparinux and unfractionated heparin), the implications of genetic polymorphisms and functional testing for antiplatelet therapy (clopidogrel and ticagrelor), new oral anticoagulants for use in atrial fibrillation (apixiban and rivaroxaban), optimal pacing strategies and pharmacological agents in heart failure (ivabradine, eplerenone, cardiac resynchronization therapy, telemonitoring and intracoronary bone marrow stem cell infusion). Clinical trials in percutaneous structural intervention (transcatheter aortic valve implantation, MONARC™ mitral annular implant, STARFlex(®) patent foramen ovale device) and advanced percutaneous coronary intervention (everolimus-eluting stents, biodegradable polymer/polymer-free technologies and contemporary use of intravascular ultrasound) are also discussed.

Topics: Angioplasty, Balloon, Coronary; Anticoagulants; Atrial Fibrillation; Cardiology; Coronary Artery Disease; Factor IXa; Fibrinolytic Agents; Fondaparinux; Heparin, Low-Molecular-Weight; Humans; Platelet Aggregation Inhibitors; Polymorphism, Genetic; Polysaccharides; Stents

One of the methods used to treat coronary artery disease (CAD) is anticoagulant therapy, which involves administering anticoagulants to patients that inhibit the arrangement and actuation of clotting factors. Anticoagulant therapy in patients with CAD must be monitored and evaluated because its greatest side effect is the risk of bleeding. The research aimed to analyze anticoagulants used in therapy for CAD patients and identify potential adverse drug reactions and adverse drug interactions.. This was an observational study which collected data retrospectively at Bhayangkara Hospital Surabaya. Patient data had to meet the requirements for inclusion, which were patients treated for a diagnosis of CAD with anticoagulant therapy and were in conditions with or without complications and comorbid diseases. Data were obtained from 40 patient medical records. The data were then processed descriptively.. Most patients were male (80%) and aged 61-70 years old (37.5%). Fondaparinux was administered to 18 patients at a dose of 1 × 2.5 mg SC. Furthermore, enoxaparin was administered to 15 patients at a dose of 2 × 60 mg SC, and seven patients received warfarin at a dose of 1 × 2-4 mg per oral.. The anticoagulants used in this study were fondaparinux 1 × 2.5 mg SC (45%), enoxaparin 2 × 60 mg SC (37.5%), and warfarin 1 × 2-4 mg PO (17.5%). Side effects of the anticoagulants were absent. However, drug interactions with aspirin, clopidogrel, and allopurinol increased the risk of bleeding.

Topics: Aged; Anticoagulants; Coronary Artery Disease; Enoxaparin; Fondaparinux; Humans; Male; Middle Aged; Retrospective Studies; Warfarin

Heparin-induced thrombocytopenia (HIT) occurs in 1 to 3% of patients after cardiac surgery. In patients with suspected or confirmed HIT, the standard of care is withheld of heparin, and an alternative, non-heparin anticoagulant substituted. An established fact is that currently only direct thrombin inhibitors (lepirudin, bivalirudin and argatroban) and heparinoids like danaparoid are approved for alternative anticoagulation in HIT patients. Herein, we report the case of a patient who developed HIT after coronary artery bypass grafting (CABG) and who was successfully treated by the factor Xa inhibitor fondaparinux. Danaparoid is our first line alternative anticoagulant to treat HIT patients. Normally the recovery from thrombocytopenia began within 24 h. In the present patient, however, platelet counts continued to fall for 3 more days. Discontinuation of danaparoid and anticoagulation with fondaparinux clearly improved platelet counts which normalized. The present patient has been treated for 26 consecutive days, and we have not observed any subsequent fall in platelet counts and any further bleeding or thrombotic complications.

Topics: Anticoagulants; Coronary Artery Bypass; Coronary Artery Disease; Diabetes Mellitus, Type 1; Drug Therapy, Combination; Fondaparinux; Heparin; Humans; Male; Middle Aged; Platelet Count; Polysaccharides; Thrombocytopenia; Treatment Outcome