O rganization to S trategies in Acute I schemic S yndromes Overall Efficacy of Fondaparinux vs Enoxaparin in VTE Prevention: Meta-analysis Fondaparinux better Enoxaparin better P = 0.000000000000000001 % odds reduction
Overall odds reduction for proximal DVT = 57.4% [CI: 72.3 - 35.6]; p = 10-6
Turpie et. al. Arch Intern Med 2002: 162: 1833-40
Baseline Characteristics Fonda (%) Therapies During Initial Hospitalization Fonda (%) 70% of patients recruited from centers with cath labs. MICHELANGELO: OASIS-5
2 of 3: Age>60, ST Δ, positive cardiac markers
opidogrel, IV GP II Clopidogrel, IV GP b/IIIa IIb/IIIa as per local practice Fondaparinux Enoxaparin Outcomes 1 mg/kg BID
•Primary: Efficacy: Death, MI, refractory ischemia 9 day Safety: Major bleeds Risk benefit: Death, MI, refractory ischemia, major bleeds
•Secondary: Above & each component (especially deaths) at 30 & 180 d • Hypothesis: First test non-inferiority, then test superiority Results: Major Bleeding: 9 Days 95% CI 0.45-0.62 ive Hazard p<<0.00001 Conclusions
Fondaparinux is “non-inferior” compared with enoxaparin at 9 days, with
substantially lower rates of important bleeds. The net benefit-risk balance clearly
Bleeding increases the risk of death significantly.
At one month and at 6 months there is a significant reduction in mortality with fondaparinux.
Strokes are also significantly reduced by fondaparinux, so that there is a clear
Consistent results are observed in those undergoing PCI (including early PCI) and
Clinical Implications :Results Treating 1000 ACS patients with fondaparinux instead of enoxaparin prevents:
- 10 deaths or MI- 4 strokes- 25 major bleeds
THE OASIS 5 TRIAL CLEARLY DEMONSTRATES THAT FONDAPARINUX IS
THE PREFERRED ANTICOAGULANT FOR TREATMENT OF ACS.
Conversion Technique - By Jack Carpenter I have never used anything other than Colchicine circulate air around the treated crowns are in my opinion (DMSO has sometimes been used) to effect conversion. The use of DMSO did not seem to cause greater amounts of conversions. I am simply not familiar with the CRITICAL importance as crown rot may occur. Always several other things I have heard
Caution In Using Celecoxib: Induction Of VEGF And Angiogenesis By This COX-2 Inhibitor H. Shu, H. Gao, K. Xu, Dept. of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA Purpose/Objective(s): Cyclooxygenase-2 (COX-2) plays a critical role in the initiation and maintenance of many cancer types and its elevated expression generally portends a worse prognosis. Gi
O rganization to 
Overall Efficacy of Fondaparinux vs Enoxaparin in VTE Prevention: 
Baseline Characteristics
Therapies During Initial Hospitalization
MICHELANGELO: OASIS-5
Results:
Conclusions
Clinical Implications :Results