PMID- 18805108
OWN - NLM
STAT- MEDLINE
DCOM- 20081104
LR  - 20151119
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 102
IP  - 7
DP  - 2008 Oct 1
TI  - Comparison of anticoagulant and anti-inflammatory responses using enoxaparin 
      versus unfractionated heparin for transesophageal echocardiography-guided 
      cardioversion of atrial fibrillation.
PG  - 842-6
LID - 10.1016/j.amjcard.2008.05.025 [doi]
AB  - The Assessment of Cardioversion Using Transesophageal Echocardiography (ACUTE) II 
      study compared enoxaparin with unfractionated heparin (UFH) as bridging therapy 
      in patients with atrial fibrillation >2 days in duration who underwent 
      transesophageal echocardiography-guided cardioversion. In the present study, the 
      anticoagulant and anti-inflammatory effects of enoxaparin and UFH were compared 
      at prespecified time points. In a randomized substudy of 155 patients from 17 
      clinical sites, the anticoagulant activity of enoxaparin (n = 76) was compared 
      with that of UFH (n = 79). Blood samples were drawn at enrollment, on day 2, and 
      on day 4 in the 2 groups. Blood samples were evaluated for anticoagulant activity 
      by measuring the activated partial thromboplastin time, anti-Xa, anti-IIa, and 
      tissue factor pathway inhibitor levels. In addition, levels of coagulation 
      activation (by thrombin antithrombin complex) and inflammation (by highly 
      sensitive C-reactive protein) were measured. The results of this substudy showed 
      that the anti-Xa levels in the 2 groups increased on day 2. Similar increases in 
      anti-Xa were observed on day 4. The anti-Xa levels and tissue factor pathway 
      inhibitor levels were higher in the enoxaparin group compared with the UFH group 
      on days 2 and 4. However, as expected, the anti-IIa levels in the UFH group were 
      higher. In addition, markers of coagulation activation and inflammation were 
      increased in patients with atrial fibrillation. Treatment with enoxaparin 
      significantly decreased thrombin antithrombin complex levels compared with 
      treatment with UFH. Highly sensitive C-reactive protein levels were also 
      decreased after treatment in the 2 groups. In conclusion, the ACUTE II study 
      showed that the use of enoxaparin for bridging therapy in patients with atrial 
      fibrillation who underwent transesophageal echocardiography-guided cardioversion 
      resulted in a more predictable and stronger anticoagulant response than that 
      observed with UFH. Markers of inflammation were also decreased in the 2 groups.
FAU - Hoppensteadt, Debra
AU  - Hoppensteadt D
AD  - Loyola University, Chicago, Illinois, USA.
FAU - Fareed, Jawed
AU  - Fareed J
FAU - Klein, Allan L
AU  - Klein AL
FAU - Jasper, Susan E
AU  - Jasper SE
FAU - Apperson-Hansen, Carolyn
AU  - Apperson-Hansen C
FAU - Lieber, Elizabeth A
AU  - Lieber EA
FAU - Katz, William E
AU  - Katz WE
FAU - Malouf, Joseph F
AU  - Malouf JF
FAU - Stoddard, Marcus F
AU  - Stoddard MF
FAU - Pape, Linda A
AU  - Pape LA
CN  - Assessment of Cardioversion Using Transesophageal Echocardiography (ACUTE) II 
      Investigators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20080709
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Biomarkers)
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Lipoproteins)
RN  - 0 (antithrombin III-protease complex)
RN  - 0 (lipoprotein-associated coagulation inhibitor)
RN  - 9000-94-6 (Antithrombin III)
RN  - 9005-49-6 (Heparin)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - EC 3.4.- (Peptide Hydrolases)
SB  - IM
MH  - Antithrombin III
MH  - Atrial Fibrillation/*therapy
MH  - Biomarkers/blood
MH  - C-Reactive Protein/analysis
MH  - Echocardiography, Transesophageal
MH  - Electric Countershock/*methods
MH  - Enoxaparin/*therapeutic use
MH  - Feasibility Studies
MH  - Female
MH  - Fibrinolytic Agents/*therapeutic use
MH  - Heparin/*therapeutic use
MH  - Humans
MH  - Lipoproteins/blood
MH  - Male
MH  - Middle Aged
MH  - Partial Thromboplastin Time
MH  - Peptide Hydrolases/blood
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - Ultrasonography, Interventional
FIR - Stoddard, Marcus F
IR  - Stoddard MF
FIR - Klein, Allan L
IR  - Klein AL
FIR - Pape, Linda
IR  - Pape L
FIR - Katz, William
IR  - Katz W
FIR - Fein, Steven
IR  - Fein S
FIR - Smith, Richard
IR  - Smith R
FIR - Klein, Marc
IR  - Klein M
FIR - Davidson, William
IR  - Davidson W
FIR - Kakavas, Peter
IR  - Kakavas P
FIR - Massey, Clara
IR  - Massey C
FIR - Malouf, Joseph F
IR  - Malouf JF
FIR - Sharifi, Mohsen
IR  - Sharifi M
FIR - Zuck, Vincent
IR  - Zuck V
FIR - Labovitz, Arthur
IR  - Labovitz A
FIR - Small, Roy
IR  - Small R
FIR - Alam, Moshin
IR  - Alam M
FIR - Mankad, Sunil
IR  - Mankad S
EDAT- 2008/09/23 09:00
MHDA- 2008/11/05 09:00
CRDT- 2008/09/23 09:00
PHST- 2008/03/24 00:00 [received]
PHST- 2008/05/14 00:00 [revised]
PHST- 2008/05/14 00:00 [accepted]
PHST- 2008/09/23 09:00 [pubmed]
PHST- 2008/11/05 09:00 [medline]
PHST- 2008/09/23 09:00 [entrez]
AID - S0002-9149(08)00907-7 [pii]
AID - 10.1016/j.amjcard.2008.05.025 [doi]
PST - ppublish
SO  - Am J Cardiol. 2008 Oct 1;102(7):842-6. doi: 10.1016/j.amjcard.2008.05.025. Epub 
      2008 Jul 9.