PMID- 18762674
OWN - NLM
STAT- MEDLINE
DCOM- 20090325
LR  - 20131121
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 20
IP  - 9
DP  - 2008 Sep
TI  - A novel point-of-care assay for the monitoring of low-molecular weight heparins 
      in the cardiac catheterization laboratory.
PG  - 449-54
AB  - BACKGROUND: We designed a study to compare the novel point-of-care assay Hemonox 
      clotting time (Hemonox-CT) with the activated clotting time (ACT) and anti-Xa 
      activity to monitor the anticoagulation effects of enoxaparin and dalteparin 
      during percutaneous coronary intervention (PCI). METHODS: A total of 90 patients 
      undergoing cardiac catheterization were assigned to intravenous (IV) enoxaparin 
      0.5 mg/kg, dalteparin 50 international units/kg or unfractionated heparin (UFH) 
      50 units/kg. We measured Hemonox-CT, ACT and plasma anti-Xa levels after serial 
      sampling. RESULTS: Baseline Hemonox-CT was similar in the enoxaparin (68 +/- 9 
      sec) and dalteparin (68 +/- 7 sec) groups with no detectable anti-Xa activity at 
      baseline. Minutes after IV administration of enoxaparin and dalteparin, the mean 
      Hemonox-CT increased to 171 +/- 60 sec and 214 +/- 70 sec for both groups, 
      respectively. UFH induced a higher Hemonox-CT response (800 +/- 243 sec). At all 
      time points, Hemonox-CT was higher than the ACT. Peak Hemonox-CT was associated 
      with a therapeutic anti-Xa activity ranging from 0.50 to 1.35 U/ml (mean 0.89 
      U/ml) for the enoxaparin group and 0.69 to 1.48 U/ml (mean 0.91 U/ml) for the 
      dalteparin group. After reaching peak levels, there was a gradual and parallel 
      decline in Hemonox-CT and anti-Xa activity. The enoxaparin and dalteparin-treated 
      patients successfully underwent PCI without major hemorrhagic complications. 
      CONCLUSIONS: The Hemonox-CT has better sensitivity to both enoxaparin and 
      dalteparin than does the ACT. Also, Hemonox-CT correlates with anti-Xa activity 
      after IV administration. Hemonox-CT may become an important tool to monitor the 
      anticoagulation effects of low-molecular weight heparin during PCI. Additional 
      studies are needed to determine the target Hemonox-CT.
FAU - Marmur, Jonathan D
AU  - Marmur JD
AD  - Department of Cardiology, SUNY Health Sciences Center at Brooklyn, 450 Clarkson 
      Avenue, Box 1257, Brooklyn, NY 11203, USA. jonathan@marmur.com
FAU - Lakhani, Manish
AU  - Lakhani M
FAU - El Rouby, Soumaya
AU  - El Rouby S
FAU - Cavusoglu, Erdal
AU  - Cavusoglu E
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - S79O08V79F (Dalteparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angioplasty, Balloon, Coronary
MH  - Anticoagulants/administration & dosage/*therapeutic use
MH  - Cardiac Catheterization/*methods
MH  - Dalteparin/administration & dosage/therapeutic use
MH  - Enoxaparin/administration & dosage/therapeutic use
MH  - Female
MH  - Heparin, Low-Molecular-Weight/administration & dosage/*therapeutic use
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Intraoperative/*methods
MH  - *Point-of-Care Systems
MH  - Sensitivity and Specificity
MH  - Whole Blood Coagulation Time/methods
EDAT- 2008/09/03 09:00
MHDA- 2009/03/26 09:00
CRDT- 2008/09/03 09:00
PHST- 2008/09/03 09:00 [pubmed]
PHST- 2009/03/26 09:00 [medline]
PHST- 2008/09/03 09:00 [entrez]
PST - ppublish
SO  - J Invasive Cardiol. 2008 Sep;20(9):449-54.