Clinical and experimental experience with factor Xa inhibitors

Juan Viles Gonzalez, Juan Gaztanaga, Urooj M. Zafar, Valentin Fuster, Juan J. Badimon

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Cardiovascular disease is the major cause of mortality in the industrial world today. We are constantly moving towards new and better ways of fighting this epidemic. Advances have been made in various fields such as patient education, imaging techniques, interventional cardiology, and novel therapeutic agents. In particular, antithrombotics are being studied with great interest and hope. Amid this class of agents, factor Xa inhibitors have already begun to show promising results in trials involving patients with acute coronary syndromes. Whereas DX-9065a is in late stage clinical trials, fondaparinux sodium is available for clinical use. Promising results have been obtained with fondaparinux sodium in patients with coronary artery disease in the PENTUA (Pentasaccharide in Unstable Angina) and PENTALYSE (Pentasaccharide as an Adjunct to Fibrinolysis in ST-Elevation Acute Myocardial Infarction) trials. Besides having a direct effect on the coagulation cascade, they have shown properties that indirectly influence the remodeling of plaques in the coronary circulation. Available evidence on factor Xa inhibitors does not ensure a remedy to acute coronary syndromes but it gives hope of improving current treatments and reducing the morbidity and mortality of cardiovascular disease. The efficacy and tolerability of fordaparinux sodium in the prevention and treatment of deep vein thrombosis (with or without pulmonary embolism) has been established in several large trials such as PENTATHLON (Pentasaccharide in Total Hip Replacement Surgery), PENTAMAKS (Pentasaccharide in Major Knee Surgery), EPHESUS (European Pentasaccharide Hip Elective Surgery), PENTHIFRA (Pentasaccharide in Hip-Fracture Surgery), and PENTHIFRA-Plus. Whereas fordaparinux sodium offers benefits over low molecular weight heparins and unfractionated heparin, the incidence of bleeding complications was greater with fondaparinux sodium than with unfractionated heparin. Treatment with factor VIIa can reverse the anticoagulant effect of fondaparinux sodium and this may be particularly important in patients who need to undergo emergency surgical procedures. Fordaparinux sodium has been recently approved for use, in conjunction with warfarin, in patients with symptomatic deep vein thrombosis or acute pulmonary embolism based on the results of two large trials conducted by the Matisse investigators. In conclusion, these observations strongly suggest the clinical potential of this class of agents in preventing arterial and venous thrombosis.

Original languageEnglish
Pages (from-to)379-384
Number of pages6
JournalAmerican Journal of Cardiovascular Drugs
Volume4
Issue number6
DOIs
StatePublished - Dec 27 2004
Externally publishedYes

Fingerprint

Venous Thrombosis
Sodium
Hip Fractures
Acute Coronary Syndrome
Pulmonary Embolism
Heparin
Cardiovascular Diseases
Factor VIIa
Coronary Circulation
Hip Replacement Arthroplasties
Mortality
Low Molecular Weight Heparin
Unstable Angina
Fibrinolysis
Warfarin
Patient Education
Therapeutics
Cardiology
Anticoagulants
Hip

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

Cite this

Viles Gonzalez, J., Gaztanaga, J., Zafar, U. M., Fuster, V., & Badimon, J. J. (2004). Clinical and experimental experience with factor Xa inhibitors. American Journal of Cardiovascular Drugs, 4(6), 379-384. https://doi.org/10.2165/00129784-200404060-00006

Clinical and experimental experience with factor Xa inhibitors. / Viles Gonzalez, Juan; Gaztanaga, Juan; Zafar, Urooj M.; Fuster, Valentin; Badimon, Juan J.

In: American Journal of Cardiovascular Drugs, Vol. 4, No. 6, 27.12.2004, p. 379-384.

Research output: Contribution to journalArticle

Viles Gonzalez, J, Gaztanaga, J, Zafar, UM, Fuster, V & Badimon, JJ 2004, 'Clinical and experimental experience with factor Xa inhibitors', American Journal of Cardiovascular Drugs, vol. 4, no. 6, pp. 379-384. https://doi.org/10.2165/00129784-200404060-00006
Viles Gonzalez, Juan ; Gaztanaga, Juan ; Zafar, Urooj M. ; Fuster, Valentin ; Badimon, Juan J. / Clinical and experimental experience with factor Xa inhibitors. In: American Journal of Cardiovascular Drugs. 2004 ; Vol. 4, No. 6. pp. 379-384.
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