Fondaparinux: A cornerstone drug in acute coronary syndromes

Table 10 Guideline recommendations for fondaparinux in acute coronary syndrome patients

AHA/ACC 2014	SC Fondaparinux for the duration of hospitalization or until PCI is performed.	2.5 mg s.c. daily	IB
ESC 2015	Fondaparinux is recommended as having the most favorable efficacy – safety profile regardless of the management strategy. In patients on Fondaparinux (2.5 mg s.c. daily) undergoing PCI, a single i.v. bolus of UFH (70-85 IU/kg, or 50-60 IU/kg in the case of concomitant use of glycoprotein IIb/IIIa inhibitors) is recommended during the procedure.	2.5 mg s.c. once daily	IB
NICE 2010	Fondaparinux is offered to patients who do not have a high bleeding risk (unless coronary angiography is planned within 24 h of admission). It should not be used in patients with significant renal dysfunction (those with a serum creatinine > 265 μmol/L were excluded from the trial).	2.5 mg s.c. once daily	NA
SIGN 2016	When there are ischemic electrocardiograph changes or elevation of cardiac markers, treat immediately with Fondaparinux. Continue for 8 d, or until hospital discharge or coronary revascularization.	2.5 mg s.c. once daily	1++
CPG Malaysian guidelines 2011	Fondaparinux for 8 d or duration of hospitalization.	2.5 mg s.c. daily	IA
SBC Brazilian guidelines 2015	Fondaparinux once a day for 8 d or until hospital discharge.	2.5 mg s.c. daily	IB

PCI: Percutaneous coronary intervention; UFH: Unfractionated heparin; NICE: National Institute for Health and Care Excellence; i.v.: Intravenous; s.c.: Subcutaneous.