Randomized, Blinded Trial Comparing Enoxaparin with Unfractionated Heparin in Patients Undergoing Contemporary Percutaneous Coronary Intervention

Abstract

Background: This study was designed to examine a unique and low dose use of intravenous enoxaparin in elective percutaneous coronary intervention (PCI) that would be applicable to an unselected population regardless of age, weight, and renal function. There is limited experience in anticoagulation using intravenous low-molecular-weight heparin in PCI. Methods: A total of 100 consecutive patients undergoing elective PCI were treated with a single IV bolus of enoxaparin (0.5mg/kg) in group A of patients (n=50) or with unfractionated heparin in group B of patients (n=50). Sheaths were removed immediately after the procedure in patients treated with enoxaparin and some hours later in those treated with unfractionated heparin. Results: In group A, ACT was 124.6±9.3 before PCI and 149.2±17.1 after that (P<0.05). In group B, one patient (2.9%) developed groin hematoma. No deaths, MI, or urgent target vessel revascularization were reported. Conclusion: Low- dose (0.5 mg/kg) IV enoxaparin allows a target level of anticoagulation in patients undergoing PCI, appears to be safe and effective, allows immediate sheath removal, and does not require dose adjustment.

Keywords

• Enoxaparin
• Low molecular weight heparin
• Unfractionated heparin
• Percutaneous coronary intervention