Why the study?
Does an IV bolus of enoxaparin 8-12 hours after SC dosing maintain target anti-Xa levels in patients undergoing PCI?
Does an IV bolus of enoxaparin 8-12 hours after SC dosing maintain target anti-Xa levels in patients undergoing PCI?
An additional 0.3 mg/kg IV bolus of enoxaparin given 8-12 hours after the last SC dose reliably maintains target anti-Xa levels during PCI.
Supports delayed IV enoxaparin bolus for anti-Xa target maintenance in PCI; hypothesis-generating, leaves clinical outcome impact open.
The objective of this study was to evaluate the pharmacokinetic response to intravenous (IV) enoxaparin given 8-12 hr after subcutaneous (SC) dosing in patients undergoing percutaneous coronary intervention (PCI). Fifty-five patients received SC enoxaparin (1 mg/kg every 12 hr) followed by an IV bolus (0.3 mg/kg) 8-12 hr after the last SC dose, at the start of PCI or during catheterization. Anti-Xa levels were within the target range in 98% of patients 2-8 hr after the last SC dose, in 96% of patients following the IV bolus, and in 91% of patients for a further 2 hr. Subcutaneous enoxaparin (1 mg/kg every 12 hr) provides sufficient anti-Xa levels for PCI 2-8 hr after the last dose. An additional 0.3 mg/kg enoxaparin dose given IV 8-12 hr after the last SC dose reliably maintains anti-Xa levels within the target for at least 2 additional hr.
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Martin et al. (2004) studied this question.
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