Monitoring of enoxaparin level using citrated clotting time during percutaneous coronary intervention.
OBJECTIVE
To evaluate the use of citrated clotting time (CCT) during percutaneous coronary intervention (PCI) in both emergent and elective scenarios and using intravenous (IV) or subcutaneous (SC) dosing.


BACKGROUND
Monitoring of enoxaparin during PCI had limitations in the past due to lack of point-of-care testing. Introduction of the CCT enables the determination of the degree of anticoagulation by enoxaparin.


RESULTS
An analysis on 51 consecutive patients revealed that after three SC doses (1 mg/kg twice a day) or a single IV bolus (1 mg/kg) of enoxaparin, the CCT was consistently in the therapeutic range of > or =260 seconds (475 +/- 105 and 565 +/- 151 sec, respectively). Patients who received < 3 SC doses of enoxaparin were subtherapeutic for PCI. A supplemental IV bolus of 0.3 mg/kg was found always to raise the CCT to therapeutic level (499 +/- 178 sec).


CONCLUSIONS
Enoxaparin was found to be effective and safe during PCI with low vascular complication rate (9.3%). Patients who received < 3 SC doses of enoxaparin benefit most from using CCT monitoring. IV dosing consistently achieved adequate anticoagulation.
Díez
Jose G
JG
Section of Cardiology, Department of Medicine, Tulane University Hospital and Clinic, 1430 Tulane Avenue SL-48, New Orleans, LA 70112, USA. jdiez@tulane.edu
Cheong
Benjamin Y C
BY
O'Meallie
Lawrence P
LP
Alt
Eckhard U
EU
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D000925:Anticoagulants / Q000008:administration & dosage / Q000097:blood*; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000628:therapy*; D016903:Drug Monitoring / Q000379:methods*; D017984:Enoxaparin / Q000008:administration & dosage / Q000097:blood*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014914:Whole Blood Coagulation Time / Q000379:methods
D000925:Anticoagulants; D017984:Enoxaparin