Please note: This work is comparing the anticoagulant fondaparinux with low-molecular-weight heparin (not heparin).
Medical Research: What is the background for this study? What are the main findings?
Dr. Szummer: Since the publication of the OASIS-5 trial in 2006, many hospitals chose to change their medical practice and start using fondaparinux instead of low-molecular-weight heparin in the treatment of myocardial infarctions. In this study from the nation-wide near-complete myocardial infarction registry we were able to follow how the use of fondaparinux instead of low-molecular-weight heparin translated in clinical life was associated to a reduction in bleeding events and death. It is a very satisfying study, that confirms that the randomized clinical trial results are transferred with improvements in outcome to the treated patients.
Medical Research: What should clinicians and patients take away from your report?
Firstly, if fondaparinux is not used in the treatment of myocardial infarction, it is a good time to consider its use.
Secondly, it is highly relevant to follow what happens in real-life when new treatments are implemented and confirm the good results seen in a selected trial.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Szummer: A recommendation would be to keep a current updated registry which enables to assess how new treatments are implemented and how they affect outcome when it reaches a wider clinical use.
Szummer K, Oldgren J, Lindhagen L, et al. Association Between the Use of Fondaparinux vs Low-Molecular-Weight Heparin and Clinical Outcomes in Patients With Non–ST-Segment Elevation Myocardial Infarction. JAMA. 2015;313(7):707-716. doi:10.1001/jama.2015.517.
MedicalResearch.com Interview with:, & Karolina Szummer, MD, PhD (2015). JAMA Study Confirms Better Anticoagulation Choice After Myocardial Infarction MedicalResearch.com