Kolluri 2016.

Methods	Randomised, placebo‐controlled, double‐blind study
Participants	Total number of participants: 78 Number of participants allocated to each group: fondaparinux group: 41, placebo group: 37 Number of participants excluded and/or lost to follow‐up: 2 participants in the fondaparinux group and no participants in the placebo group withdrew; all randomised participants were analysed. Inclusion criteria: All patients scheduled to undergo a first or a repeat isolated CABG operation were considered for enrolment in the study. Exclusion criteria Long‐term anticoagulation with unfractionated or low molecular weight heparin, coumadin or heparinoids Contraindications to anticoagulation Creatinine clearance < 30 mL/min Body weight < 50 kg Presence of indwelling epidural catheter Hepatic failure Pregnant state Life expectancy < 6 months Platelet count < 100,000/mm3 Whole blood haemoglobin concentration < 9 g/dL Venous thromboembolism documented within past 3 months Acute bacterial endocarditis Cerebral metastasis or abscess History of heparin‐induced thrombocytopaenia Presence of acute deep venous thrombosis on preoperative duplex ultrasonography of lower extremities Inability to undergo venous duplex of lower extremities Inability to consent Refusal by treating physician
Interventions	Fondaparinux (FX): Intervention group received 2.5 mg subcutaneous injections of fondaparinux sodium daily, starting at a mean of 12 ± 2 hours after wound closure or on the morning of the first postoperative day. Second dose was administered at a mean of 24 ± 2 hours after the first dose, and subsequent injections were administered once daily for 9 days or until the patient was discharged from the hospital, whichever happened first. Placebo: Control group received similar amounts of subcutaneous isotonic saline on the same schedule as the intervention group.
Outcomes	Primary study endpoint: composite, up to day 11, of cumulative incidence of all VTE events, defined as symptomatic and asymptomatic DVT, and fatal and non‐fatal pulmonary embolisms Primary safety endpoint: cumulative incidence of major haemorrhages
Notes	Use of adjunctive anticoagulative methods: Both groups routinely received graduated compression stockings and/or intermittent pneumatic compression (mechanical antithrombotic prophylaxis).
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "This study was conducted in compliance with the Good Clinical Practice guidelines" Comment: probably done
Allocation concealment (selection bias)	Low risk	Quote: "This study was conducted in compliance with the Good Clinical Practice guidelines" Comment: probably done
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Quote: "The control group received similar amounts of subcutaneous isotonic saline on the same schedule as the interventional group" Comment: probably done
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Quote: "Patients who developed symptomatic DVT or VTE underwent DUS scan of the lower extremities. An independent Data and Safety Monitoring Board monitored the safety of the study." Comment: probably done
Incomplete outcome data (attrition bias) All outcomes	Low risk	Quote: "Two patients in the fondaparinux group, who withdrew their consent at 3 and 8 days post enrollment, respectively, did not undergo DUS and were removed from the study. Clinical follow‐ups were complete in 76 patients (97.4%)" Comment: probably done
Selective reporting (reporting bias)	Low risk	All primary efficacy and safety outcomes listed in the Methods section were reported. Comment: low risk of bias
Other bias	Low risk	No other bias noted