Systematic review of efficacy and safety of fondaparinux in the treatment of non-ST-elevation acute coronary syndrome in China
- VernacularTitle:磺达肝癸钠治疗中国非ST段抬高急性冠状动脉综合征疗效与安全性的系统评价
- Author:
Xingxing XIE
1
;
Jie ZHANG
2
;
Xiaodong FAN
3
;
Yilong LIU
4
;
Feihong HUANG
5
;
Bin YU
6
;
Ling FAN
1
Author Information
1. Dept. of Pharmacy，Ya’an People’s Hospital，Sichuan Ya’an 625000，China
2. Dept. of Pharmacy，Nanbu County People’s Hospital，Sichuan Nanchong 637300，China
3. Dept. of Pharmacy，Xichong County People’s Hospital，Sichuan Nanchong 637200，China
4. Dept. of Pharmacy，Leshan People’s Hospital，Sichuan Leshan 614000，China
5. Dept. of Pharmacology，Southwest Medical University，Sichuan Luzhou 646000，China
6. Dept. of Pharmacy，Mianyang Central Hospital，Sichuan Mian yang 621000，China
- Publication Type:Journal Article
- Keywords:
non-ST-elevation acute coronary syndrom;
fondaparinux;
low molecular weight heparin;
venous thromboembolism
- From:
China Pharmacy
2022;33(7):879-884
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the efficacy and safety of fondaparinux versus low molecular weight heparin（nadroparin，enoxaparin）in the treatment of non-ST-elevation acute coronary syndrome （NSTE-ACS）. METHODS The computer searched PubMed ，Medline，Embase，EBSCO，CNKI，Wanfang medical network ，VIP Chinese Journal Full-text Database and relevant clinical trial registration network for the clinical retrospective cohort study （RCS）of fondaparinux （as trial group）and low molecular weight heparin （natroparin，enoxaparin）（as control group ）in the treatment of NSTE-ACS. The retrieval time limit was from the establishment of the database to August 2021. Newcastle Ottawa scale （NOS）was used to evaluate the quality of literature. Outcome indicators included primary efficacy indicators （incidence of acute myocardial infarction and recurrent angina pectoris during hospitalization ），secondary efficacy indicators [revascularization of target vessels during 话：0835-2862024。E-mail：xiexingxing07@163.com hospitalization， prothrombin time （PT）， activated partial thromboplastin time （APTT）]，safety indicators （incidence of serious cardiovascular events ，severe bleeding ，slight bleeding and severe puncture site co mplications during hospitalization ），combined endpoint indicators （30 and 180 days combined endpoint）. RevMan 5.3 software was used for Meta-analysis of each effect index. RESULTS Finally，17 RCS articles were included，involving 4 946 patients with NSTE-ACS ，including 2 507 in the trial group and 2 439 in the control group.The results of NOS literature quality evaluation showed that there were 8 high-quality studies ，accounting for 47.06％ . The results of Meta-analysis showed that there was no significant difference in the incidence of acute myocardial infarction ，recurrent angina pectoris，revascularization of target vessels ，PT and serious cardiovascular events between 2 groups （P＞0.05）；there was significant difference in the APTT （MD＝1.34，95％CI of 0.22-2.45，P＜0.05），the incidence of severe bleeding （RR＝0.47， 95％CI of 0.30-0.74，P＜0.05），the incidence of slight bleeding （RR＝0.48，95％CI of 0.32-0.71，P＜0.05），the incidence of severe puncture site complications （RR＝0.48，95％CI of 0.25-0.95，P＜0.05），30 day combined endpoint （RR＝0.57，95％CI of 0.46-0.72，P＜0.05），180 days combined endpoint （RR＝0.73，95％CI of 0.54-0.98，P＜0.05）. CONCLUSIONS Fondaparinux in the treatment of NSTE-ACS in China has the same efficacy as low molecular weight heparin （nadroparin，enoxaparin），and has more obvious advantages in drug safety such as bleeding ，severe puncture site complications.
