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Association between the Use of Fondaparinux Plus Radial Access and Clinical Outcomes in Patients with Non-ST

Luiz Eduardo Fonteles Ritt1,2, Eduardo Sahade Darze1,2, Pedro Gabriel Melo de Barros E Silva3

  • 1Instituto D'Or de Pesquisa e Ensino, Hospital Cardio Pulmonar, BA - Brasil.

Arquivos Brasileiros De Cardiologia
|December 11, 2025
PubMed

Insights

Combining fondaparinux and radial access significantly lowers major adverse cardiovascular events (MACE) and bleeding in acute coronary syndrome (ACS) patients. This strategy offers superior outcomes compared to other anticoagulation and access site combinations.

Area of Science:

  • Cardiology
  • Clinical Trials
  • Pharmacology

Background:

  • Fondaparinux and radial access are individually linked to reduced major adverse cardiovascular events (MACE) in acute coronary syndrome (ACS).
  • Investigating the combined effect of these strategies is crucial for optimizing patient care in ACS.

Purpose of the Study:

  • To evaluate the combined impact of fondaparinux and radial access on clinical outcomes in ACS patients.
  • To compare the efficacy and safety of fondaparinux plus radial access against other anticoagulation and arterial access combinations.

Main Methods:

  • Analysis of 956 ACS patients undergoing invasive procedures.
  • Primary outcome: composite of major bleeding (OASIS-5 criteria) and MACE.
  • Comparison across four groups: fondaparinux/enoxaparin with femoral/radial access.

Main Results:

  • The combination of fondaparinux and radial access demonstrated the lowest event rate (3.3%).
  • Fondaparinux use was associated with a 43% reduction in the primary outcome (OR, 0.57; p < 0.05).
  • Radial access independently reduced the primary outcome by 54% (OR, 0.46; p = 0.01).

Conclusions:

  • The concurrent use of fondaparinux and radial access is associated with the lowest rates of MACE and major bleeding in ACS.
  • This combination strategy appears superior to using either fondaparinux or radial access alone, or in combination with enoxaparin or femoral access, respectively.
Abstract

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