PMID- 12424505
OWN - NLM
STAT- MEDLINE
DCOM- 20030221
LR  - 20191106
IS  - 1075-2765 (Print)
IS  - 1075-2765 (Linking)
VI  - 9
IP  - 6
DP  - 2002 Nov-Dec
TI  - Safety and efficacy of combined use of low molecular weight heparin (enoxaparin, 
      lovenox) and glycoprotein IIb/IIIa receptor antagonist (eptifibatide, integrelin) 
      during nonemergent coronary and peripheral vascular intervention.
PG  - 488-91
AB  - Coronary and peripheral intervention requires intraprocedural anticoagulation to 
      prevent intraluminal thrombosis. Traditionally, unfractionated heparin (UFH) is 
      administered during the procedure to achieve activated clotting time (ACT) of 300 
      to 400 seconds. When the intravenous IIb/IIIa antagonists are also used, the 
      recommended ACT is 250 to 300 seconds because higher anticoagulation (ACT, 
      300-400 seconds) is accompanied by an unacceptable bleeding complication rate 
      without added benefits. Because low molecular weight heparin has a more 
      predictable anticoagulant effect and a higher anti-factor Xa/anti-factor IIa 
      ratio, allows better bioavailability, is resistant to inhibition by activated 
      platelets, and does not require routine monitoring using ACT, its use for 
      intraprocedural anticoagulation (instead of UFH) has been an area of increasing 
      interest. The safety and efficacy of coadministration of low molecular weight 
      heparin with IIb/IIIa antagonists have not been adequately evaluated. We report a 
      study of prospective evaluation of the safety and efficacy of combined use of 
      intravenous enoxaparin and intravenous eptifibatide during nonemergent coronary 
      and peripheral vascular intervention in 93 consecutive procedures performed on 56 
      patients. The procedural success rate was 99% (92/93 procedures), the acute 
      clinical success rate was 98% (54/55 patients), the major bleeding complication 
      rate was 2% (1/56 patients), and the vascular complication rate was 0.0%. In 
      conclusion, the use of intravenous enoxaparin in conjunction with intravenous 
      eptifibatide during nonemergent coronary and peripheral vascular intervention is 
      safe and effective and eliminates the need for routine measurement of ACT during 
      the procedure.
FAU - Khosla, Sandeep
AU  - Khosla S
AD  - Section of Cardiology and Endovascular Therapeutics, Mount Sinai Hospital 
      Chicago, IL 60608, USA. khos@sinai.org
FAU - Kunjummen, Binu
AU  - Kunjummen B
FAU - Guerrero, Mayra
AU  - Guerrero M
FAU - Manda, Ravi
AU  - Manda R
FAU - Razminia, Mansoor
AU  - Razminia M
FAU - Trivedi, Atul
AU  - Trivedi A
FAU - Vidyarthi, Vasundhara
AU  - Vidyarthi V
FAU - Elbazour, Monther
AU  - Elbazour M
FAU - Ahmed, Aziz
AU  - Ahmed A
FAU - Lubell, David
AU  - Lubell D
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Am J Ther
JT  - American journal of therapeutics
JID - 9441347
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Peptides)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - NA8320J834 (Eptifibatide)
SB  - IM
MH  - *Angioplasty, Balloon, Coronary
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Comorbidity
MH  - Coronary Disease/*therapy
MH  - Drug Therapy, Combination
MH  - Enoxaparin/administration & dosage/*therapeutic use
MH  - Eptifibatide
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Peptides/*therapeutic use
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
MH  - Prospective Studies
EDAT- 2002/11/09 04:00
MHDA- 2003/02/22 04:00
CRDT- 2002/11/09 04:00
PHST- 2002/11/09 04:00 [pubmed]
PHST- 2003/02/22 04:00 [medline]
PHST- 2002/11/09 04:00 [entrez]
AID - 10.1097/00045391-200211000-00005 [doi]
PST - ppublish
SO  - Am J Ther. 2002 Nov-Dec;9(6):488-91. doi: 10.1097/00045391-200211000-00005.