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Vol 28, No 4 (2022)
Research paper
Published online: 2022-12-30

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Comparison between unfractionated heparin (UFH) and fondaparinux on platelets and D-dimer level in COVID-19 patients with hypercoagulation

Meity Ardiana1, Hanestya Oky Hermawan1, Primasitha Maharany Harsoyo1, Inna Maya Sufiyah1, Mohammad Fahrizal Fanani1
Acta Angiologica 2022;28(4):161-165.


Introduction: This study aimed to compare the clinical effects between UFH and fondaparinux
in COVID-19 patients with hypercoagulation.

Material and methods: This was a prospective cohort study. Samples were taken consecutively from hospitalized
COVID-19 patients with hypercoagulation who received UFH or fondaparinux based on the standardized
guidelines. A total of 71 patients met the inclusion criteria. Patients were evaluated for platelet and D-dimer
values before and after administration of UFH or fondaparinux.

Results: Although there was no difference in D-dimer reduction between the two groups (p = 0.44), fondaparinux
showed a greater reduction, 26% against 22% for UFH. While on platelets, there was a significant
difference (p = 0.04) between fondaparinux and UFH. Fondaparinux showed a reduced thrombocytopenia
impact, as seen by an increase in pre- and post-therapy platelets of up to 50%, compared to 16% in UFH.
In regard to the incidence of Heparin-Induced Thrombocytopenia (HIT), there was no significant difference
between post-UFH therapy and post-fondaparinux therapy (p = 0.361).

Conclusion: Fondaparinux did not reduce platelet levels as much as UFH, but there was no difference
between the fondaparinux group compared to the UFH group in the effect of decreasing D-dimer levels and
the sign of HIT.

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