Fondaparinux (Arixtra®) should be recommended as an option for use in the treatment of ST segment elevation myocardial infarction (STEMI) in patients who are managed with thrombolytics or who are initially to receive no other form of reperfusion therapy. Treatment with fondaparinux (Arixtra®) and its monitoring/supervision should be retained under secondary care. AWMSG is of the opinion that fondaparinux (Arixtra®) would not be suitable for shared care within NHS Wales.