Fondaparinux vs. low molecular weight heparin in bleeding risk of acute coronary syndrome: meta-analysis of prospective studies

AIM:To compare the safety between fondaparinux and low molecular weight heparin (LMWH) in patients with acute coronary syndrome (ACS), excluding ST-segment elevation myocardial infarction (STEMI). METHODS: The authors applied the techniques of meta-analysis to data extracted from the published literature addressing this relation. RESULTS: Five trials with a total of 20680 patients were included. Compared with LMWH, fondaparinux was associated with reduced major bleeding (risk ratio ［RR］=0.53; 95% CI: 0.45 to 0.61; Z=8.10; P<0.01), minor bleeding (RR=0.33, 95% CI: 0.27 to 0.41; Z=10.30, P<0.01) and total bleeding (RR=0.44, 95% CI: 0.39 to 0.50; Z=13.03, P<0.01). CONCLUSION: Fondaparinux is safer than low molecular weight heparin in anticoagulant treatment of ACS.