Of 55 million deaths globally every year, about 30 percent are from cardiovascular diseases. Of these, 40 percent to 50 percent are likely to be due to acute myocardial infarction (AMI heart attack). Primary percutaneous coronary intervention (PCI - procedures such as angioplasty in which a catheter-guided balloon is used to open a narrowed coronary artery) offers benefits over thrombolytic therapy (medication that breaks up clots), but access to this procedure, particularly in developing countries, is limited. Advances in treatments are likely to have a greater public health and clinical impact if they are effective, safe, simple to administer, affordable, and applicable to a widely diverse spectrum of economic and health care settings, according to background information in the article. Trials of medications such as unfractionated heparin (UFH), direct thrombin inhibitors, and enoxaparin have thus far failed to demonstrate reductions in the death rate, and bleeding is substantially increased when these agents are used with aspirin and thrombolytic therapy. There is a clear need for an effective, inexpensive, and safe antithrombotic agent for patients with STEMI (ST-segment elevation myocardial infarction a certain characteristic pattern on an electrocardiogram associated with a heart attack).
Salim Yusuf, D.Phil., F.R.C.P.C., F.R.S.C., of McMaster University and Hamilton Health Services, Ontario, Canada, and colleagues with the OASIS-6 Trial conducted a study to evaluate the effect of fondaparinux compared with
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