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Reduced Thrombin Generation and Soluble P-selectin After Intravenous Enoxaparin During PCI

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Abstract

Purpose

The objective of our study was to identify changes in the coagulation and serum concentration of soluble P-selectin (sP-sel) after i.v. bolus of 0.75 mg/kg enoxaparin in a group of 33 patients during PCI.

Methods and results

As compared to baseline, i.v. enoxaparin increased anti -Xa activity and FIIa inhibition together with APTT and thrombin time tests within 20 min, that persisted for 60 min. At 6 h, the results of all tests had returned to baseline. In contrast, the level of prothrombin fragments (F1 + 2) decreased persistingly for a period of 6 h (baseline 1.19 ± 0.42 nmol/l, after 20 min 1.03 ± 0.46 nmol/l, after 60 min 1.06 ± 0.43 nmol/l, after 6 h 0.95 ± 0.40 nmol/l, p < 0.001 vs. baseline for all values). In addition, i.v. enoxaparin decreased serum sP-sel level (baseline 111.80 ± 37.05 ng/ml, after 20 min 87.80 ± 33.17 ng/ml, after 60 min 86.45 ± 29.15 ng/ml, after 6 h 92.24 ± 31.34 ng/ml, p < 0.001 vs. baseline value for all). sP-sel level mildly correlated with both F Xa inhibition (r = −0.275, p < 0.05) and F1 + 2 level (r = 0.274, p < 0.05).

Conclusion

Intravenous enoxaparin induced target F Xa inhibition (>0.6 IU/ml) for 60 min in 82% of study patients. During the 6 h of monitoring, a decrease of thrombin generation (F1 + 2) and sP-selectin levels were observed.

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Acknowledgements

This work was supported by grants from the Ministry of Health Czech Republic: MZOVFN2005 and NT 11176–5.

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Authors and Affiliations

  1. Center for Thrombosis Research, General Teaching Hospital, Charles University, Karlovo n. 32, Prague, 121 11, Czech Republic

    J. Kvasnička, Z. Zenáhlíková, Tomáš Kvasnička & I. Malíková

  2. 2nd Department of Internal Medicine, General Teaching Hospital, Charles University, U nemocnice 2, Prague, Czech Republic

    J. Horák, S. Šimek, T. Kovárník, A. Linhart & M. Aschermann

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  1. J. Kvasnička
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  2. J. Horák
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Correspondence to Tomáš Kvasnička.

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Kvasnička, J., Horák, J., Zenáhlíková, Z. et al. Reduced Thrombin Generation and Soluble P-selectin After Intravenous Enoxaparin During PCI. Cardiovasc Drugs Ther 25, 243–250 (2011). https://doi.org/10.1007/s10557-011-6301-0

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