American Heart Journal
Volume 143, Issue 5 , Pages 753-759 , May 2002

Influence of patient characteristics and renal function on factor Xa inhibition pharmacokinetics and pharmacodynamics after enoxaparin administration in non-ST-segment elevation acute coronary syndromes

Received 12 March 2001 ,Accepted 3 October 2001.

References 

  1. Fuster V, Badimon L, Badimon JJ, et al.  The pathophysiology of coronary artery disease and the acute coronary syndromes. N Engl J Med. 1992;326:242-50–310-58
  2. Braunwald E, Mark DB, Jones RH, et al.  Unstable angina: diagnosis and management. In: Agency for Healthcare Policy and Research and the National Heart, Lung, Blood Institute, Public Health Services, US Department of Health and Human Services; 1994;p. 154; Clinical practice guidelines No. 10
  3. Hirsh J, Levin M. Low molecular weight heparin. Blood. 1993;79:1–17
  4. Jones CA, McQuillan GM, Kusek JW, et al.  Serum creatinine levels in the US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis. 1998;32:992–999
  5. The USRDS Dialysis Morbidity , Mortality Study . US Renal Data System. Am J Kidney Dis. 1997;30(1 Suppl):S67–S85
  6. Rocco MV, Soucie JM, Reboussin DM, et al.  Risk factors for hospital utilization in chronic dialysis patients. J Am Soc Nephrol. 1996;7:889–896 Southeastern Kidney Council (Network 6)
  7. Deutsch E, Berstein RC, Addonizio VP, et al.  Coronary artery bypass surgery in patients in chronic hemodialysis: a case-control study. Ann Intern Med. 1989;110:369–372
  8. Owen CH, Cummings RG, Sell TL, Schwab SJ, Jones RH, Glower DD. Coronary artery bypass grafting in patients with dialysis-dependent renal failure. Ann Thorac Surg. 1994;58:1729–1733
  9. Rao V, Weisel RD, Buth KJ, et al.  Coronary artery bypass grafting in patients with non-dialysis dependent renal insufficiency. Circulation. 1997;96(2 Suppl):II38–II45
  10. Antman E, for the TIMI 9A, Investigators . Hirudin in acute myocardial infarction: safety report from the Thrombolysis and Thrombin Inhibition in acute Myocardial Infarction (TIMI) 9A Trial. Circulation. 1994;90:1624–1630
  11. Dose-ranging trial of enoxaparin for unstable angina: results of TIMI 11A. Thrombolysis In Myocardial Infarction 11A Investigators. J Am Coll Cardiol. 1997;29:1474–1482
  12. Teien AN, Abildgaard U. Assay of heparin in plasma using a chromogenic substrate for activated factor X. Thromb Res. 1976;8:413–416
  13. Aich M, Roncato M. Practical considerations on the measurement of low molecular weight heparin and anti-Xa activity. Semin Thromb Haemost. 1985;11:108–111
  14. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16:31–41
  15. Fragmin-During-Instability-In-Coronary-Artery-Disease Study Group . Low molecular weight heparin during instability in coronary artery disease. Lancet. 1996;347:561–568
  16. Klein W, Buchwald A, Hillis SE, et al.  Comparison of low-molecular-weight heparin with unfractionated heparin acutely and with placebo for 6 weeks in the management of unstable coronary artery disease. Fragmin in unstable coronary artery disease study. Circulation. 1997;96:61–68
  17. Cohen M, Demers C, Gurfinkel EP, et al.  A comparison of low molecular-weight heparin with unfractionated heparin for unstable coronary artery disease. Efficacy and Safety of Subcutaneous Enoxaparin in Non-Q-Wave Coronary Events Study Group. N Engl J Med. 1997;337:447–452
  18. Antman EM, McCabe CH, Gurfinkel EP, et al.  Enoxaparin prevents death and cardiac ischemic events in unstable angina/non-Q-wave myocardial infarction. Results of the Thrombolysis in Myocardial Infarction (TIMI) 11B trial. Circulation. 1999;100:1593–1601
  19. Braunwald E, Antman EM, Beasley JW, et al.  ACC/AHA guidelines for the management of patients with unstable angina and non-ST segment elevation myocardial infarction. J Am Coll Cardiol. 2000;36:970–1062
  20. In:  Dalen JE,  Hirsh J editor. Sixth ACCP Consensus Conference on Antithrombotic Therapy. Chest. 119:2001;p. 1S–370
  21. Campbell RWF, Wallentin L, Verheught FWA, et al.  Management strategies for a better outcome in unstable coronary artery disease. Clin Cardiol. 1998;21:314–322
  22. Davies MJ, Thomas A. Thrombosis and acute coronary lesions in sudden ischemic cardiac deaths. N Engl J Med. 1984;310:1137–1140
  23. Falk E. Unstable angina with fatal outcome: dynamic coronary thrombosis leading to infarction and/or sudden death. Circulation. 1985;71:699–708
  24. Mann KG, Lawson JH. The role of the membrane in the expression of the vitamin K-dependent enzymes. Arch Pathol Lab Med. 1992;116:1330–1336
  25. Spencer FA, Ball SP, Zhang Q, et al.  Enoxaparin, a low molecular weight heparin, inhibits platelet-dependent prothrombinase assembly and activity by factor Xa neutralization. J Thromb Thrombolysis. 2000;9:223–228
  26. Melandri G, Semprini F, Cervi V, et al.  Comparison of the efficacy of low molecular weight heparin (parnaparin) with that of unfractionated heparin in the presence of activated platelets in healthy subjects. Am J Cardiol. 1993;72:450–454
  27. Dehmer GJ, Fisher M, Tate DA, et al.  Reversal of heparin anticoagulation by recombinant platelet factor 4 in humans. Circulation. 1995;91:2188–2194
  28. Landolfi R, de Candia E, Rocca B, et al.  Effects of unfractionated and low molecular weight heparins on platelet thromboxane biosynthesis “in vivo”. Thromb Haemost. 1994;72:942–946
  29. Young E, Walls P, Holloway S, et al.  Ex vivo and in vitro evidence that low molecular weight heparin exhibits less binding to plasma proteins than unfractionated heparin. Thromb Haemost. 1994;71:300–304
  30. van Ginneken CAM, Russel FGM. Saturable pharmacokinetics in the renal excretion of drugs. Clin Pharmacokinet. 1989;16:38–54
  31. Albada J, Nieuwenhuis HK, Sixma JJ. Pharmacokinetics of standard and low molecular weight heparin. In:  Lane Da,  Lindah U editor. Heparin: chemical and biological properties: clinical applications. London: Edward Arnold; 1989;p. 417–432
  32. Ellis V, Scully MF, Kakkar VV. The relative molecular mass dependence of the anti-factor Xa properties of heparin. Biochem J. 1986;238:329–333
  33. Boneu B, Caranobe C, Sie P. Pharmacokinetics of heparin and low molecular weight heparins. Baillieres Clin Haematol. 1990;3:531–544
  34. Holm HA, Ly B, Handeland GF, et al.  Subcutaneous heparin treatment of deep venous thrombosis: a comparison of unfractionated and low molecular weight heparin. Haemostasis. 1986;16:30–37 (Suppl)
  35. Montalescot G, Polle V, Collet JP, et al.  Low molecular weight heparin after mechanical heart valve replacement. Circulation. 2000;101:1083–1086
  36. Caranobe C, Barret A, Gabaig AM, et al.  Disappearance of circulating anti-Xa activity after intravenous injection of standard heparin and of low molecular weight heparin (CY 216) in normal and binephrectomized rabbits. Thromb Res. 1985;40:129–133
  37. Palm M, Mattsson C. Pharmacokinetics of heparin and low molecular weight heparin fragment (Fragmin) in rabbits with impaired renal or metabolic clearance. Thromb Haemost. 1987;58:932–935
  38. Cadroy Y, Pourrat J, Baladre MF, et al.  Delayed elimination of enoxaparin in patients with chronic renal insufficiency. Thromb Res. 1991;63:385–390 [brief communication]
  39. Follea G, Laville M, Pozet N, et al.  Pharmacokinetic studies of standard heparin and low molecular weight heparin in patients with chronic renal failure. Haemostasis. 1986;16:147–151
  40. Goudable C, Ton That H, Damani A, et al.  Low molecular weight heparin half-life is prolonged in haemodialysed patients. Thromb Res. 1986;43:1–5

☆ Reprint requests: Richard C. Becker, MD, Director, Cardiovascular Thrombosis Research Center, University of Massachusetts Medical School, Worcester, MA 01655.

PII: S0002-8703(02)02296-2

doi: 10.1067/mhj.2002.120774

American Heart Journal
Volume 143, Issue 5 , Pages 753-759 , May 2002

Article Tools

* Image Usage & Resolution