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Assessment of anticoagulation using activated clotting times in patients receiving intravenous enoxaparin during percutaneous coronary intervention
Author(s) -
Lawrence Mark,
Mixon Timothy A.,
Cross Donald,
Gantt D. Scott,
Dehmer Gregory J.
Publication year - 2004
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.10683
Subject(s) - medicine , activated clotting time , conventional pci , enoxaparin sodium , eptifibatide , percutaneous coronary intervention , anesthesia , thrombus , abciximab , heparin , surgery , low molecular weight heparin , myocardial infarction
Enoxaparin is being used more frequently in patients undergoing percutaneous coronary intervention (PCI). In this study, we determined the effect of intravenous enoxaparin on activated clotting time (ACT) measurements in the setting of PCI. In 67 consecutive patients, either 1 mg/kg intravenous enoxaparin alone was given for anticoagulation or 0.75 mg/kg given in patients receiving eptifibatide. ACT was measured before and 5 min following enoxaparin administration. After 1 mg/kg enoxaparin (n = 22), mean ACT increased from 122 ± 22 to 199 ± 20 sec. After 0.75 mg/kg enoxaparin and eptifibatide (n = 45), mean ACT increased from 125 ± 22 to 194 ± 24 sec. The mean increase in ACT was 77 ± 26 sec in the 1 mg/kg group and 69 ± 23 sec in the 0.75 mg/kg group (both P values < 0.0001). Moreover, in a subgroup of 26 patients, there was an excellent correlation (r = 0.86) between ACTs and the ENOX test, a new point‐of‐care test for assessing enoxaparin anticoagulation. None of the patients had transient abrupt closure, thrombus formation, major bleeding, or required urgent revascularization. Intravenous enoxaparin at clinically relevant doses with and without eptifibatide increases ACT levels at 5 min in patients undergoing PCI. These data suggest the ACT may be useful in the assessment of anticoagulation by enoxaparin. Catheter Cardiovasc Interv 2004;61:52–55. © 2004 Wiley‐Liss, Inc.