6/28/23, 11:44 PM OASIS-5 Pathway Feedback Search Clinical Topics Home Studies OASIS 5 OASIS 5 Disease Non-ST-elevation myocardial inf Trial question What is the effect of fondaparinux in patients with acute coronary syndromes? Study design Multi-center Double blinded RCT Population Characteristics of study participants 38.0% female N = 20078 62.0% male 20078 patients (7699 female, 12379 male) Inclusion criteria: patients with acute coronary syndromes Key exclusion criteria: contraindications to LMWH, recent hemorrhagic stroke, indications for anticoagulation other than an acute coronary syndrome, or a serum creatinine level of at least 3 mg/dL Interventions N=10057 fondaparinux (2.5 mg daily for a mean of 6 days) N=10021 enoxaparin (1 mg/kg body weight BID for a mean of 6 days) Primary outcome Death, myocardial infarction, or refractory ischemia at 9 days https://web.pathway.md/studies/recCIbYikm6e5O41G 1/2 6/28/23, 11:44 PM OASIS-5 Pathway 5.8 % 5.8 5.7 4.3 % 2.9 % Difference not exceeding nonferiority margin 1.4 % 0.0 % Fondaparinux Enoxaparin Difference not exceeding nonferiority margin in death, myocardial infarction, or refractory ischemia at 9 days (5.8% vs. 5.7%; HR 1.01, 95% CI 0.9 to 1.13) Secondary outcomes No significant difference in death or myocardial infarction at day 30 (6.2% vs. 6.8%; HR 0.9, 95% CI 0.81 to 1.01) Significant decrease in death at 30 days (2.9% vs. 3.5%; HR 0.83, 95% CI 0.71 to 0.97) Significant decrease in death, MI, refractory ischemia, or major bleeding at day 30 (10.2% vs. 12.4%; HR 0.82, 95% CI 0.75 to 0.89) Safety outcomes Significant differences in major bleeding at 9 days (2.2% vs. 4.1%), at 30 days (3.1% vs. 5.0%), and at 180 days (4.3% vs. 5.8%). Conclusion In patients with acute coronary syndromes, fondaparinux was noninferior to enoxaparin with respect to death, myocardial infarction, or refractory ischemia at 9 days. Reference Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators, Yusuf S, Mehta SR et al. Comparison of fondaparinux and enoxaparin in acute coronary syndromes. N Engl J Med. 2006 Apr 6;354(14):1464-76. Open reference URL https://web.pathway.md/studies/recCIbYikm6e5O41G 2/2