PMID- 16079447
OWN - NLM
STAT- MEDLINE
DCOM- 20050927
LR  - 20220408
IS  - 1042-3931 (Print)
IS  - 1042-3931 (Linking)
VI  - 17
IP  - 8
DP  - 2005 Aug
TI  - The activated clotting time (ACT) can be used to monitor enoxaparin and 
      dalteparin after intravenous administration.
PG  - 416-21
AB  - BACKGROUND: The use of low-molecular weight heparin (LMWH) during percutaneous 
      coronary intervention (PCI) has been limited by the presumed inability to monitor 
      its anticoagulant effect using bedside assays. OBJECTIVES: This study was 
      designed to compare the dose-response of enoxaparin, dalteparin and 
      unfractionated heparin (UFH) on the activated clotting time (ACT), and to 
      determine whether the ACT or aPTT can be used to monitor intravenous (IV) low 
      molecular weight heparin (LMWH). METHODS: A total of 130 patients undergoing 
      cardiac catheterization were assigned to intravenous enoxaparin 0.5 mg/kg, 
      dalteparin 50 international units/kg or UFH 50 units/kg. Of the 130 patients, 46 
      (35%) underwent PCI, all of whom received a glycoprotein (GP) IIb/IIIa inhibitor. 
      We measured ACT, activated partial thromboplastin time (aPTT) and plasma anti-Xa 
      levels after serial sampling. RESULTS: Both enoxaparin and dalteparin induced a 
      significant rise in the ACT and aPTT, with an ACT dose-response approximately 
      one-half the magnitude of that obtained using UFH. The time course of changes in 
      the ACT and aPTT after administration of enoxaparin and dalteparin was virtually 
      identical, with a return to baseline at approximately 2 hours. The enoxaparin and 
      dalteparin-treated patients successfully underwent PCI with no major hemorrhagic 
      complications. CONCLUSIONS: The ACT is equally sensitive to IV enoxaparin and 
      dalteparin. These data support an ACT-guided strategy for intravenously 
      administered LMWH during PCI. Additional studies with larger patient populations 
      may be indicated to determine the ideal target ACT for LMWH in PCI.
FAU - Cavusoglu, Erdal
AU  - Cavusoglu E
AD  - Division of Cardiology, Department of Medicine, the Bronx Veterans Administration 
      Medical Center, Bronx, NY, USA.
FAU - Lakhani, Manish
AU  - Lakhani M
FAU - Marmur, Jonathan D
AU  - Marmur JD
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - S79O08V79F (Dalteparin)
SB  - IM
MH  - Angina Pectoris/*blood/diagnosis
MH  - Anticoagulants/*administration & dosage
MH  - Blood Coagulation/*drug effects
MH  - Cardiac Catheterization
MH  - Coronary Angiography
MH  - Dalteparin/*administration & dosage
MH  - Enoxaparin/*administration & dosage
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Injections, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Safety
MH  - Thrombosis/prevention & control
MH  - Whole Blood Coagulation Time/methods
EDAT- 2005/08/05 09:00
MHDA- 2005/09/28 09:00
CRDT- 2005/08/05 09:00
PHST- 2005/08/05 09:00 [pubmed]
PHST- 2005/09/28 09:00 [medline]
PHST- 2005/08/05 09:00 [entrez]
PST - ppublish
SO  - J Invasive Cardiol. 2005 Aug;17(8):416-21.