title: Stable and optimal anticoagulation is achieved with a single dose of intravenous enoxaparin in patients undergoing percutaneous coronary intervention.
abstract: This study assessed the pharmacokinetics, safety and efficacy of intravenous enoxaparin in patients undergoing percutaneous coronary intervention (PCI). Sixty consecutive patients [(age, 62   11 years; female, 16%; diabetes, 18%; hypertension, 53%; prior myocardial infarction (MI), 43%] undergoing PCI (stable angina, 89%; stent, 92%; two-vessel disease, 23%; B2/C lesions, 45%) were administered intravenous enoxaparin 1 mg/kg for procedural anticoagulation. Blood samples for anti-Xa level and activated partial thromboplastin time (aPTT) were assayed from the first 20 patients before and after enoxaparin administration at the following intervals: 5, 30, 60, 90, 120, 150, 180, 210, 240, 360 and 480 minutes. Activated clotting time was assessed 5 minutes after enoxaparin administration. Bleeding complications were classified according to Thrombolysis In Myocardial Infarction (TIMI) criteria. All patients were monitored for adverse clinical events at clinic visit 4 8 weeks after hospital discharge. No TIMI major or minor bleedings occurred during hospitalization for the PCI (median stay post-PCI = 1 day). One patient (2%) developed a non-Q wave MI after the PCI and before hospital discharge. There was no death or urgent revascularization up to clinical follow-up. The peak anti-Xa level was 1.30   0.18 IU/ml (range, 1.03 1.69 IU/ml). The minimum anti-Xa level was 0.55 IU/ml 4 hours after enoxaparin. Thus, the use of intravenous enoxaparin in patients undergoing PCI is associated with a low incidence of ischemic and bleeding complications. A stable therapeutic anticoagulant effect is provided without the need for monitoring within 4 hours of enoxaparin administration.
authors.affiliation: Department of Medicine, Queen Mary Hospital, Hong Kong, China.
authors.forename: Wai-Hong
authors.initials: WH
authors.lastname: Chen
authors.forename: Chu-Pak
authors.initials: CP
authors.lastname: Lau
authors.forename: Yuk-Kong
authors.initials: YK
authors.lastname: Lau
authors.forename: William
authors.initials: W
authors.lastname: Ng
authors.forename: Pui-Yin
authors.initials: PY
authors.lastname: Lee
authors.forename: Cheuk-Man
authors.initials: CM
authors.lastname: Yu
authors.forename: Edmond
authors.initials: E
authors.lastname: Ma
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000008:administration & dosage*; D002681:China; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000150:complications / Q000628:therapy; D017984:Enoxaparin / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D010314:Partial Thromboplastin Time; D011183:Postoperative Complications / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014914:Whole Blood Coagulation Time
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin