Reliable anticoagulation with enoxaparin in patients undergoing percutaneous coronary intervention: The pharmacokinetics of enoxaparin in PCI (PEPCI) study

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Abstract
The objective of this study was to evaluate the pharmacokinetic response to intravenous (IV) enoxaparin given 8–12 hr after subcutaneous (SC) dosing in patients undergoing percutaneous coronary intervention (PCI). Fifty‐five patients received SC enoxaparin (1 mg/kg every 12 hr) followed by an IV bolus (0.3 mg/kg) 8–12 hr after the last SC dose, at the start of PCI or during catheterization. Anti‐Xa levels were within the target range in 98% of patients 2–8 hr after the last SC dose, in 96% of patients following the IV bolus, and in 91% of patients for a further 2 hr. Subcutaneous enoxaparin (1 mg/kg every 12 hr) provides sufficient anti‐Xa levels for PCI 2–8 hr after the last dose. An additional 0.3 mg/kg enoxaparin dose given IV 8–12 hr after the last SC dose reliably maintains anti‐Xa levels within the target for at least 2 additional hr. Catheter Cardiovasc Interv 2004;61:163–170.