Anti-Xa activity relates to survival and efficacy in unselected acute coronary syndrome patients treated with enoxaparin

Low-molecular-weight heparin (LMWH) is recommended in the treatment of unstable angina (UA)/non-ST-segment-elevation myocardial infarction (NSTEMI), but no relationship has ever been shown between anticoagulation levels obtained with LMWH treatment and clinical outcomes. In all, 803 consecutive pati...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2004-07, Vol.110 (4), p.392-398
Main Authors: Montalescot, G, Collet, J P, Tanguy, M L, Ankri, A, Payot, L, Dumaine, R, Choussat, R, Beygui, F, Gallois, V, Thomas, D
Format: Article
Language:English
Subjects:
Aged
Angina, Unstable - blood
Angina, Unstable - drug therapy
Angina, Unstable - mortality
Angina, Unstable - therapy
Angioplasty, Balloon, Coronary
Anticoagulants - administration & dosage
Anticoagulants - adverse effects
Anticoagulants - pharmacology
Anticoagulants - therapeutic use
Biomarkers
Cardiac Catheterization
Cohort Studies
Combined Modality Therapy
Creatine Kinase - blood
Creatine Kinase, MB Form
Drug Therapy, Combination
Enoxaparin - administration & dosage
Enoxaparin - adverse effects
Enoxaparin - pharmacology
Enoxaparin - therapeutic use
Factor Xa Inhibitors
Female
Follow-Up Studies
Hemorrhage - chemically induced
Hemorrhage - epidemiology
Humans
Isoenzymes - blood
Male
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - drug therapy
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Prospective Studies
Survival Analysis
Ticlopidine - administration & dosage
Ticlopidine - analogs & derivatives
Ticlopidine - therapeutic use
Treatment Outcome
Troponin I - blood
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Summary:Low-molecular-weight heparin (LMWH) is recommended in the treatment of unstable angina (UA)/non-ST-segment-elevation myocardial infarction (NSTEMI), but no relationship has ever been shown between anticoagulation levels obtained with LMWH treatment and clinical outcomes. In all, 803 consecutive patients with UA/NSTEMI were treated with subcutaneous enoxaparin and were followed up for 30 days. The recommended dose of enoxaparin of 1 mg/kg BID was used throughout the population except when physicians decided on dose reduction because of a history of a recent bleeding event or because of a high bleeding risk. Anti-factor Xa activity was >0.5 IU/mL in 93% of patients; subtherapeutic anti-Xa levels (
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.0000136830.65073.C7