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Updated: Jun 5, 2026
Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Use of low-molecular-weight heparins during percutaneous coronary intervention
Jack L Martin1, Marvin Slepian
1Sharpe-Strumia Research Foundation, 130 S. Bryn Mawr Avenue, Bryn Mawr Hospital, 2nd Floor/DWing, Bryn Mawr, PA 19010, USA. MartinJ@MLHS.org
Insights
Enoxaparin offers effective anticoagulation for acute coronary syndromes (ACS) patients transitioning to percutaneous coronary intervention (PCI). New data support specific dosing for seamless integration from emergency care to catheterization, addressing physician uncertainty.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Acute coronary syndromes (ACS) management often involves anticoagulation.
- Transitioning ACS patients to percutaneous coronary intervention (PCI) requires careful consideration of prior anticoagulation.
- Enoxaparin is increasingly used in emergency settings for ACS due to its efficacy and simplicity.
Purpose of the Study:
- To review the pharmacokinetics of enoxaparin.
- To provide recommendations for enoxaparin dosing in ACS patients undergoing PCI.
- To address physician uncertainty regarding enoxaparin use during the transition to catheterization.
Main Methods:
- Review of enoxaparin pharmacokinetics.
- Analysis of recent clinical and pharmacodynamic data.
- Development of dosing recommendations based on presentation timing and pre-catheterization administration.
Main Results:
- Enoxaparin demonstrates effectiveness in ACS management.
- Established dosing schedules facilitate a smooth transition to PCI.
- New data support specific regimens for catheterization laboratory use.
Conclusions:
- Optimized enoxaparin dosing ensures adequate anticoagulation for ACS patients undergoing PCI.
- Clear recommendations can alleviate physician concerns about enoxaparin use.
- Pharmacokinetic and clinical data guide seamless anticoagulation management from emergency to intervention.
Abstract:
Patients with acute coronary syndromes (ACS) may transition to percutaneous coronary intervention (PCI) after an initial phase of medical management that includes anticoagulation. When patients come to the catheterization laboratory, it is important to consider previously received anticoagulation. Enoxaparin has emerged as a more effective, yet simple, agent for use in the emergency room or upon initial encounter of the ACS patient. However, there may be uncertainty among physicians on the adequacy and way to use anticoagulation in the transition to the catheterization laboratory. Recently, new data have emerged on the use of enoxaparin in the catheterization laboratory. Dosing schedules based on pharmacodynamic and clinical data offer a seamless transition for enoxaparin from the medical management phase to PCI. In this paper, the pharmacokinetics of enoxaparin are reviewed and recommendations for anticoagulant regimens provided based upon the timing of presentation and pre-catheterization dosing.
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