A unique, low dose of intravenous enoxaparin in elective percutaneous coronary intervention

Choussat, R.; Montalescot, Gilles; Collet, Jean Philippe; Vicaut, Éric; Ankri, Annick; Gallois, Vanessa; Drobinski, G; Sotirov, Ivan; Thomas, Daniel

doi:10.1016/s0735-1097(02)02531-7

Cited by 113 publications

(86 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An analytical range of 0.5-1 U/ml is appropriate for PCI [29,30] and the fluorogenic assay presented here covers this therapeutic range as well as low dose enoxaparin (0.2-0.8 U/ml).…”

Section: Discussionmentioning

confidence: 99%

Development of a fluorescent anti-factor Xa assay to monitor unfractionated and low molecular weight heparins

Harris

Castro-López

Hammadi

et al. 2010

Talanta

View full text Add to dashboard Cite

Fluorogenic assays have many potential advantages over traditional clot-based and chromogenic assays such as the absence of interference from a range of factor deficiencies as well as offering the possibility of assays in platelet rich plasma or whole blood. A fluorogenic anti-factor Xa (anti-FXa) assay has been developed for the determination of heparin-like anticoagulants including unfractionated heparin (UFH), low-molecular weight heparins (LMWHs), namely enoxaparin and tinzaparin, and the synthetic heparinoid danaparoid, in commercial human pooled plasma. The assay was based on the complexation of heparinspiked plasmas with exogenous FXa at a concentration of 4 nM in the presence of 0.9 µM of the fluorogenic substrate methylsulfonyl-D-cyclohexylalanyl-glycyl-arginine-7-amino-4-methylcoumarin acetate (Pefafluor FXa). Pooled plasma samples were spiked with concentrations of anticoagulants in the range 0 to 1.6 U/ml. The assay was capable of the measurement of UFH and danaparoid in the range 0-1 U/ml, and enoxaparin and tinzaparin in the range 0-0.8 U/ml and 0-0.6 U/ml, respectively. Assay percentage coefficients of variation were typically below 7 %.3

show abstract

“…An analytical range of 0.5-1 U/ml is appropriate for PCI [29,30] and the fluorogenic assay presented here covers this therapeutic range as well as low dose enoxaparin (0.2-0.8 U/ml).…”

Section: Discussionmentioning

confidence: 99%

Development of a fluorescent anti-factor Xa assay to monitor unfractionated and low molecular weight heparins

Harris

Castro-López

Hammadi

et al. 2010

Talanta

View full text Add to dashboard Cite

show abstract

“…The effects of enoxaparin on responses to exercise were probably underestimated because we chose a dosage regimen without continuous infusion, 19 and the plasma levels of enoxaparin may have decreased importantly at the postexercise sampling. 21 Similarly, additional administration of enoxaparin may be appropriate during prolonged coronary interventions when enoxaparin is given as an intravenous bolus.…”

Section: Discussionmentioning

confidence: 99%

Platelet Activity, Coagulation, and Fibrinolysis During Exercise in Healthy Males

Blombäck

et al. 2007

ATVB

View full text Add to dashboard Cite

Background-Relationships between exercise-induced activation of platelets, blood coagulation, and fibrinolysis, and the importance of thrombin for responses to exercise are not clear. Methods and Results-Effects of thrombin inhibition on hemostatic parameters were examined in a double-blind crossover study comparing the direct thrombin inhibitor argatroban (350 g/kg intravenous bolus followed by 25 g/kg per minute of infusion), the indirect thrombin inhibitor enoxaparin (0.75 mg/kg, intravenous bolus), or placebo (saline) in 21 healthy males. Measurements were made at rest, before and during/after thrombin inhibitor treatment, and immediately after exhaustive exercise. At rest argatroban abolished, and enoxaparin attenuated platelet activation by thrombin, but not by adenosine diphosphate. Argatroban and, even more so, enoxaparin decreased thrombin generation (prothrombin F1ϩ2) and the coagulation potential, and increased the fibrinolytic potential. Exercise increased circulating activated platelets (from 5.5Ϯ0.3 to 9.4Ϯ0.9ϫ10 9 /L; PϽ0.001), circulating platelet-platelet microaggregates, the platelet responsiveness to in vitro stimulation, leukocyte activation (leukocyte CD11b expression and plasma elastase), and platelet-leukocyte aggregation (PϽ0.01 for all). Exercise increased coagulation (F1ϩ2; PϽ0.01) and fibrinolysis, but did not alter the balance between them; fibrin gel permeability increased (PϽ0.01), probably because of release of endogenous tissue plasminogen activator from the vessel wall. Neither argatroban nor enoxaparin counteracted exercise-induced platelet or leukocyte activation. Both thrombin inhibitors augmented exercise effects on fibrinolysis. Conclusions-Strenuous exercise enhances platelet and leukocyte activation independently of thrombin. Exercise augments both coagulation and fibrinolysis, but the balance between them appears to be maintained. At therapeutic dosages argatroban counteracted thrombin-induced platelet activation most efficiently, whereas enoxaparin had somewhat stronger anticoagulant and profibrinolytic effects.

show abstract

“…Es verdad que en el metaanálisis de exclusivamente los 8 estudios aleatorizados 22-25 no se encontraron diferencias significativas entre los dos tipos de tratamiento, pero sí una fuerte tendencia a que la utilización de HBPM intravenosa sin monitorizar en el laboratorio de cateterismo era tan segura y eficaz como la utilización de HNF con monitorización de TCA, esta tendencia también se observó en menos hemorragias en el grupo de HBPM. Sin embargo, cuando se incluyeron en el análisis los 7 estudios no aleatorizados 5,[26][27][28][29] , sí se encontraron diferencias a favor de la utilización de las HBPM. El problema es que ninguno de los 15 estudios utilizados en este metaanálisis tenía poder estadístico adecuado para obtener conclusiones definitivas.…”

Section: Discussionunclassified

“…La utilización de HBPM, se ha incrementado en los últimos años en el contexto de SCA e ICP electivo [3][4][5][6] . Las HBPM tienen ventajas potenciales sobre la HNF, como una más estable y predecible respuesta de la anticoagulación, que obvia la necesidad de monitorización, una mayor vida media y un mayor índice de actividad contra el factor Xa frente a actividad del factor IIa, el cual reduce la generación y la activación de trombina 7 .…”

Section: Introductionunclassified

Eficacia y seguridad de la enoxaparina en la angioplastia primaria. Análisis comparativo con la heparina no fraccionada

et al. 2009

View full text Add to dashboard Cite

Objetivo. El objetivo de este estudio es comparar el efecto de la enoxaparina (ENX) y la heparina no fraccionada (HNF) intravenosas en la angioplastia primaria (AP) del infarto agudo de miocardio (IAMCEST).Diseño. Estudio prospectivo observacional. Pácientes y método. Se incluyó en el estudio a 191 pacientes con IAMCEST a los que se había realizado AP. En 91 (47,6%) se utilizó ENX y en 100 (52,4%), HNF. La elección del tratamiento se realizó a criterio del operador. Se excluyó a los pacientes con shock cardiogénico. Los pacientes recibieron un bolo intravenoso de ENX (0,75 o 1 mg/kg) o HNF (70 o 100 U/kg), dependiendo si se lo combinaba con abciximab o no. Se realizó seguimiento intrahospitalario evaluando la mortalidad y las complicaciones hemorrágicas de ambos tratamientos.Resultados. La mortalidad hospitalaria fue del 1,1% en el grupo ENX y del 3,3% en el grupo HNF (p = 0,359). Tampoco se encontraron diferencias significativas en el número de complicaciones hemorrágicas con ENX (4,4%) y con HNF (9%). Hubo 1 trombosis aguda o subaguda de stent con ENX y 3 con HNF. No se encontraron diferencias significativas en el tamaño del infarto medido con troponina I (63,1 con ENX y 54,8 con HNF) ni en la fracción de eyección del ventrículo izquierdo al alta hospitalaria (el 51% con ENX y el 49,4% con HNF).Conclusiones. La AP puede realizarse de forma segura con la administración intravenosa de ENX, pues no se ha encontrado diferencias significativas entre los dos tratamientos ni en mortalidad ni en complicaciones hemorrágicas.PALABRAS CLAVE: Angioplastia coronaria. Enoxaparina. Stent. Infarto de miocardio.

show abstract

A unique, low dose of intravenous enoxaparin in elective percutaneous coronary intervention

Cited by 113 publications

References 22 publications

Development of a fluorescent anti-factor Xa assay to monitor unfractionated and low molecular weight heparins

Development of a fluorescent anti-factor Xa assay to monitor unfractionated and low molecular weight heparins

Platelet Activity, Coagulation, and Fibrinolysis During Exercise in Healthy Males

Eficacia y seguridad de la enoxaparina en la angioplastia primaria. Análisis comparativo con la heparina no fraccionada

Contact Info

Product

Resources

About