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The Drug, the Strategy, the Environment, or All of the Above?

Robert M. Califf, MD

JAMA. 2006;295:1579-1580. Published online March 14, 2006 (doi:10.1001/jama.295.13.jed60020).

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Antithrombotic therapy has become a major defense against the assault of atherosclerosis on society, and accordingly, "atherothrombosis" has become a commonly accepted term in the cardiovascular practice community. Understandably, exploration of the biology of atherothrombosis has led to the development of a variety of drugs intended to block coagulation and thereby prevent arterial thrombosis. The OASIS (Organization to Assess Strategies for Ischemic Syndromes) 6 trial reported in this issue of JAMA by the OASIS-6 Trial Group¹ represents another major milestone in this remarkable saga.

The OASIS-6 investigators conducted a large and complex trial assessing a strategy of use of fondaparinux in ST-elevation myocardial infarction (STEMI). Fondaparinux is a synthetic pentasaccharide that inhibits factor Xa in the coagulation cascade, in contrast to heparin, which predominately blocks thrombin, and to the low-molecular-weight species of heparin, which have mixed effects depending on the specific formulation. OASIS 6 is one . . . [Full Text of this Article]

Author Affiliation: Duke Clincal Research Institute, Durham, NC.

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