Effect of enoxaparin on peak and trough levels of antifactor Xa in patients with a creatinine clearance of less than 30 mL/min

AIM: To assess whether there was an increased risk of bleeding with enoxaparin in patients with a creatinine clearance (CCT) of less than 30 mL/min. METHODS: Patients with a CCT of less than 30 mL/min who were given enoxaparin 1 mg/kg/day were included. Antifactor Xa levels (peak and trough) were measured after three doses (days) of enoxaparin. The peak antifactor Xa levels were measured 4 h after the third enoxaparin dose, and the trough levels of antifactor Xa were measured 12 h and 24 h after the third enoxaparin dose. Basic demographic data such as age, sex, race, diagnosis and creatinine values were assessed at baseline. Adverse events were monitored and recorded. Domain-specific review board approval was obtained before the present study began. RESULTS: A total of 15 patients were recruited for the present study. Three patients dropped out of the study; therefore, 12 patients were analyzed. The mean age of the 12 patients was 69.25 years (range 41 to 89 years). There were six men and an equal number of women. There were eight Chinese patients, three Malay patients and one Indian patient. The indication for anticoagulation was deep vein thrombosis in seven patients, non-ST elevation myocardial infarction in four patients and atrial fibrillation in one patient. There were no adverse events noted in any patient. CONCLUSION: It is safe to administer enoxaparin once a day to patients with renal impairment and a CCT of less than 30 mL/min.