A landmark international study, coordinated by McMaster University, has found that lower doses of a blood thinner called unfractionated heparin (UFH) during angioplasty did not reduce bleeding or vascular complications compared to standard dose UFH in patients initially treated with a blood thinner, fondaparinux.
In a prior study, the OASIS 5 trial, researchers from McMaster University showed that a blood thinner fondaparinux compared to another blood thinner, enoxaparin, reduced serious bleeding and prevented deaths in patients with heart attacks. A limitation of this new agent, fondaparinux, was its higher rates of clot formation in equipment during angioplasty. As a result, an additional blood thinner UFH had been recommended during angioplasty to prevent clotting in those who had received fondaparinux, but there was uncertainty about the optimal dose.
Even though UFH has been used during angioplasty since the procedure was first performed, little is known about the optimal dose of the agent.
An international group of researchers from 18 countries found patients undergoing angioplasty did not benefit from a lower dose of UFH compared to a standard dose in those on fondaparinux.
Importantly, the addition of either low or standard dose UFH to fondaparinux did not increase serious bleeding and prevented clot formation in equipment during angioplasty when compared to patients treated with fondaparinux alone in OASIS 5. As a result, adding standard dose UFH to fondaparinux maintains the major advantage of fondaparinux (lower bleeding) while preventing clotting during the angioplasty procedure.
"Our data clearly shows that adding UFH to fondaparinux maintains a low rate of major bleeding and prevents catheter thrombosis," said interventional cardiologist Dr. Sanjit Jolly, an assistant professor of medicine in the Michael G. DeGroote School of Medicine at McMaster University.
Dr. Jolly is scheduled to prese
|Contact: Laura Thompson|