July 13, 2004Circulation
Anti-Xa Activity Relates to Survival and Efficacy in Unselected Acute Coronary Syndrome Patients Treated With Enoxaparin
Why the study?
Does subtherapeutic anti-Xa activity during enoxaparin treatment increase 30-day mortality in patients with UA/NSTEMI?
Population
803 consecutive patients with unstable angina (UA) or non-ST-segment-elevation myocardial infarction (NSTEMI)
Comparison
Subcutaneous enoxaparin resulting in… vs Subcutaneous enoxaparin resulting in target…
Design
Cohort
Follow-up
30 days
Authors
Discussion
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Member takes
Implication
Subtherapeutic anti-Xa may signal higher UA/NSTEMI mortality; hypothesis-generating and requires RCTs before guiding enoxaparin dosing.
Structured PICO
Does subtherapeutic anti-Xa activity during enoxaparin treatment increase 30-day mortality in patients with UA/NSTEMI?
P
Population
803 consecutive patients with unstable angina (UA) or non-ST-segment-elevation myocardial infarction (NSTEMI)
I
Intervention
Subcutaneous enoxaparin (recommended dose 1 mg/kg BID) resulting in subtherapeutic anti-Xa levels (<0.5 IU/mL)
C
Comparator
Subcutaneous enoxaparin resulting in target range anti-Xa levels (0.5 to 1.2 IU/mL)
O
Outcome
30-day mortality ratehard clinical
In patients with UA/NSTEMI treated with enoxaparin, achieving an anti-Xa level of at least 0.5 IU/mL is crucial, as subtherapeutic levels are independently associated with increased 30-day mortality.
Cite This Study
Montalescot et al. (2004) studied this question.