Key result
The use of abciximab with enoxaparin during PCI did not affect enoxaparin pharmacokinetics, which demonstrated a clearance of 10 mL/h/kg and an elimination rate constant of 0.22/h across both groups.
Why the study?
Does the addition of abciximab to enoxaparin alter the pharmacokinetics of enoxaparin in patients undergoing percutaneous coronary intervention?
Cohort (n=1,054)
Does the addition of abciximab to enoxaparin alter the pharmacokinetics of enoxaparin in patients undergoing percutaneous coronary intervention?
The concurrent use of abciximab with enoxaparin during percutaneous coronary intervention does not alter the pharmacokinetic profile of enoxaparin.
May support combined use without enoxaparin adjustment in PCI; leaves open randomized confirmation.
The pharmacokinetic profile of enoxaparin was established in a substudy involving 1054 patients undergoing percutaneous coronary intervention. Patients enrolled in the National Investigators Collaborating on Enoxaparin 1 (NICE-1) trial received enoxaparin as a 1.0-mg/kg intravenous bolus. Patients enrolled in the NICE-4 trial received enoxaparin as a 0.75-mg/kg intravenous bolus followed by abciximab as a 0.25-mg/kg bolus and a 0.125-mcg/kg/min 12-hour infusion. Blood samples were collected at six time points over 12 hours and analyzed for plasma anti-Xa, anti-IIa, and Heptest (Haemachem Inc., St. Louis, MO) activity using specific and sensitive assay methods. Data were similar in both trials. Plasma anti-Xa, anti-IIa, and Heptest activity peaked shortly after the enoxaparin bolus and declined in parallel over the ensuing 12 hours. Area under the curve and peak activity were greatest for Heptest activity and least for anti-IIa activity. Values for clearance, volume of distribution, volume of distribution at steady state, and elimination rate constant were on the order of 10 mL/h/kg, 48 mL/kg, 45 mL/kg, and 0.22/h, respectively. These measures suggest that the use of abciximab in combination with enoxaparin during percutaneous coronary intervention is unlikely to affect the pharmacokinetics of enoxaparin.
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Argenti et al. (2003) conducted a cohort in Percutaneous coronary intervention (n=1,054). Enoxaparin with abciximab vs. Enoxaparin 1.0-mg/kg IV bolus alone was evaluated on Pharmacokinetic profile (plasma anti-Xa, anti-IIa, and Heptest activity). The use of abciximab with enoxaparin during PCI did not affect enoxaparin pharmacokinetics, which demonstrated a clearance of 10 mL/h/kg and an elimination rate constant of 0.22/h across both groups.
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