Organization to Assess Strategies in Acute Ischemic Syndrome (OASIS) trial (OASIS-5, OASIS-6)

Introduction

OASIS-5:

• 20,078 patients mean age 67 with unstable angina or non-STEMI

Treatment:

• fondaparinux 2.5 mg QD
• enoxaparin 1 mg/kg BID
• mean treatment duration 6 days

Outcome:

• primary outcome: death, MI, refractory ischemia at 9 days

Results:

• primary outcome was the same 5.7-5.8%
• risk of bleeding less with fondaparinux 2.2% vs 4.1%
• mortality at 30 days lower with fondaparinux 2.9% vs 3.5%

OASIS-6:

• 12, 092 patients, mean age 62 with STEMI

Treatment:

• fondaparinux 2.5 mg QD vs usual care (heparin or placebo)

Results:

• 45% received fibrinolysis (generally streptokinase)
• 29% received PCI
• incidence of death or reinfarction significantly lower with fondaparinux than usual care 9.7% vs 11.2%
• benefit seen at 9 days & 3-6 months
• trend towards less bleeding in fondaparinux group
• benefit NOT seen in patients who received PCI
• more catheter thrombosis during PCI in fondaparinux group 1.2% vs 0%

More general terms

• clinical trial

Additional terms

• fondaparinux (Arixtra)