Reliable anticoagulation with enoxaparin in patients undergoing percutaneous coronary intervention: The pharmacokinetics of enoxaparin in PCI (PEPCI) study.
The objective of this study was to evaluate the pharmacokinetic response to intravenous (IV) enoxaparin given 8-12 hr after subcutaneous (SC) dosing in patients undergoing percutaneous coronary intervention (PCI). Fifty-five patients received SC enoxaparin (1 mg/kg every 12 hr) followed by an IV bolus (0.3 mg/kg) 8-12 hr after the last SC dose, at the start of PCI or during catheterization. Anti-Xa levels were within the target range in 98% of patients 2-8 hr after the last SC dose, in 96% of patients following the IV bolus, and in 91% of patients for a further 2 hr. Subcutaneous enoxaparin (1 mg/kg every 12 hr) provides sufficient anti-Xa levels for PCI 2-8 hr after the last dose. An additional 0.3 mg/kg enoxaparin dose given IV 8-12 hr after the last SC dose reliably maintains anti-Xa levels within the target for at least 2 additional hr.
Martin
Jack L
JL
John S. Sharpe Research Foundation, Bryn Mawr Hospital, Bryn Mawr, Pennsylvania, USA. martinj@mlhs.org
Fry
Edward T A
ET
Sanderink
Ger-Jan C M
GJ
Atherley
Trevor H
TH
Guimart
Colette M
CM
Chevalier
Paul J
PJ
Ozoux
Marie-Laure
ML
Pensyl
Catherine E
CE
Bigonzi
Frederique
F
D000293:Adolescent; D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000008:administration & dosage / Q000493:pharmacokinetics*; D017023:Coronary Angiography; D017984:Enoxaparin / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy*; D011446:Prospective Studies
D000925:Anticoagulants; D017984:Enoxaparin