Journal of Thrombosis and Thrombolysis

, Volume 28, Issue 2, pp 224–228

The pharmacodynamics of enoxaparin in percutaneous coronary intervention with precise rapid enoxaparin loading (PEPCI-PRE study)

  • Jack L. Martin
  • Edward T. A. Fry
  • Todd Martin
  • Trevor H. Atherley
  • Seth S. Martin
  • Marvin J. Slepian
Article

DOI: 10.1007/s11239-009-0326-2

Cite this article as:
Martin, J.L., Fry, E.T.A., Martin, T. et al. J Thromb Thrombolysis (2009) 28: 224. doi:10.1007/s11239-009-0326-2

Abstract

Objective We evaluated the early pharmacodynamic profile of the combined 30 mg intravenous and 1 mg/kg subcutaneous enoxaparin loading utilized in the TIMI 11B and ExTRACT TIMI 25 trials. Background It has not been reported whether anti-Xa levels appropriate for percutaneous coronary intervention (PCI) can be reliably achieved within 2 h utilizing this regimen. Methods Twenty-six patients with acute coronary syndrome (ACS) treated with this regimen had anti-Xa levels measured at 5 min, 2, 4, 6 and 8 h. Results Seventy-six percent of patients had anti-Xa levels above 0.5 IU/ml at 5 min. Dose-response curves showed all patients to have anti-Xa levels above 0.5 IU/ml within 1 h. Anti-Xa remained in the targeted range for PCI (0.5 to 1.8 IU/ml) at 2, 4, 6 and 8 h in all patients. Conclusion This regimen is well suited for ACS treatment with an invasive strategy, including the rapid transition to early and rescue PCI.

Keywords

Low molecular weight heparin Anti-Xa levels Acute coronary syndromes Early invasive management 

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Jack L. Martin
    • 1
  • Edward T. A. Fry
    • 2
  • Todd Martin
    • 3
  • Trevor H. Atherley
    • 4
  • Seth S. Martin
    • 5
  • Marvin J. Slepian
    • 6
  1. 1.Main Line HealthSharpe-Strumia Research Foundation, Bryn Mawr HospitalBryn MawrUSA
  2. 2.The Care Group, LLCSt. Vincent HospitalIndianapolisUSA
  3. 3.Main Line HealthThe Lankenau HospitalWynnewoodUSA
  4. 4.Newark Beth Israel Medical CenterNewarkUSA
  5. 5.Department of MedicineDuke University Medical CenterDurhamUSA
  6. 6.Sarver Heart CenterUniversity of ArizonaTucsonUSA

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