title: Use of low-molecular-weight heparins during percutaneous coronary intervention.
abstract: Patients with acute coronary syndromes (ACS) may transition to percutaneous coronary intervention (PCI) after an initial phase of medical management that includes anticoagulation. When patients come to the catheterization laboratory, it is important to consider previously received anticoagulation. Enoxaparin has emerged as a more effective, yet simple, agent for use in the emergency room or upon initial encounter of the ACS patient. However, there may be uncertainty among physicians on the adequacy and way to use anticoagulation in the transition to the catheterization laboratory. Recently, new data have emerged on the use of enoxaparin in the catheterization laboratory. Dosing schedules based on pharmacodynamic and clinical data offer a seamless transition for enoxaparin from the medical management phase to PCI. In this paper, the pharmacokinetics of enoxaparin are reviewed and recommendations for anticoagulant regimens provided based upon the timing of presentation and pre-catheterization dosing.
authors.affiliation: Sharpe-Strumia Research Foundation, 130 S. Bryn Mawr Avenue, Bryn Mawr Hospital, 2nd Floor/DWing, Bryn Mawr, PA 19010, USA. MartinJ@MLHS.org
authors.forename: Jack L
authors.initials: JL
authors.lastname: Martin
authors.forename: Marvin
authors.initials: M
authors.lastname: Slepian
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D000818:Animals; D000925:Anticoagulants / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D006328:Cardiac Catheterization; D004305:Dose-Response Relationship, Drug; D004632:Emergency Medical Services; D017984:Enoxaparin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007279:Injections, Subcutaneous; D007668:Kidney / Q000187:drug effects; D009203:Myocardial Infarction / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D015912:Thrombolytic Therapy / Q000379:methods*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin