The pharmacodynamics of enoxaparin in percutaneous coronary intervention with precise rapid enoxaparin loading (PEPCI-PRE study).
OBJECTIVE
We evaluated the early pharmacodynamic profile of the combined 30 mg intravenous and 1 mg/kg subcutaneous enoxaparin loading utilized in the TIMI 11B and ExTRACT TIMI 25 trials.


BACKGROUND
It has not been reported whether anti-Xa levels appropriate for percutaneous coronary intervention (PCI) can be reliably achieved within 2 h utilizing this regimen.


METHODS
Twenty-six patients with acute coronary syndrome (ACS) treated with this regimen had anti-Xa levels measured at 5 min, 2, 4, 6 and 8 h.


RESULTS
Seventy-six percent of patients had anti-Xa levels above 0.5 IU/ml at 5 min. Dose-response curves showed all patients to have anti-Xa levels above 0.5 IU/ml within 1 h. Anti-Xa remained in the targeted range for PCI (0.5 to 1.8 IU/ml) at 2, 4, 6 and 8 h in all patients.


CONCLUSIONS
This regimen is well suited for ACS treatment with an invasive strategy, including the rapid transition to early and rescue PCI.
Martin
Jack L
JL
Main Line Health, Sharpe-Strumia Research Foundation, Bryn Mawr Hospital, Bryn Mawr, PA 19010, USA. MartinJ@mlhs.org
Fry
Edward T A
ET
Martin
Todd
T
Atherley
Trevor H
TH
Martin
Seth S
SS
Slepian
Marvin J
MJ
D054058:Acute Coronary Syndrome / Q000628:therapy; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000008:administration & dosage / Q000493:pharmacokinetics*; D017984:Enoxaparin / Q000008:administration & dosage / Q000493:pharmacokinetics*; D065427:Factor Xa Inhibitors; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000925:Anticoagulants; D017984:Enoxaparin; D065427:Factor Xa Inhibitors