Reduced thrombin generation and soluble P-selectin after intravenous enoxaparin during PCI

Cardiovasc Drugs Ther. 2011 Jun;25(3):243-50. doi: 10.1007/s10557-011-6301-0.

Abstract

Purpose: The objective of our study was to identify changes in the coagulation and serum concentration of soluble P-selectin (sP-sel) after i.v. bolus of 0.75 mg/kg enoxaparin in a group of 33 patients during PCI.

Methods and results: As compared to baseline, i.v. enoxaparin increased anti -Xa activity and FIIa inhibition together with APTT and thrombin time tests within 20 min, that persisted for 60 min. At 6 h, the results of all tests had returned to baseline. In contrast, the level of prothrombin fragments (F1 + 2) decreased persistingly for a period of 6 h (baseline 1.19 ± 0.42 nmol/l, after 20 min 1.03 ± 0.46 nmol/l, after 60 min 1.06 ± 0.43 nmol/l, after 6 h 0.95 ± 0.40 nmol/l, p < 0.001 vs. baseline for all values). In addition, i.v. enoxaparin decreased serum sP-sel level (baseline 111.80 ± 37.05 ng/ml, after 20 min 87.80 ± 33.17 ng/ml, after 60 min 86.45 ± 29.15 ng/ml, after 6 h 92.24 ± 31.34 ng/ml, p < 0.001 vs. baseline value for all). sP-sel level mildly correlated with both F Xa inhibition (r = -0.275, p < 0.05) and F1 + 2 level (r = 0.274, p < 0.05).

Conclusion: Intravenous enoxaparin induced target F Xa inhibition (>0.6 IU/ml) for 60 min in 82% of study patients. During the 6 h of monitoring, a decrease of thrombin generation (F1 + 2) and sP-selectin levels were observed.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / methods*
  • Anticoagulants / pharmacology
  • Coronary Artery Disease / therapy
  • Enoxaparin / pharmacology*
  • Factor Xa Inhibitors
  • Female
  • Humans
  • Injections, Intravenous
  • Male
  • Middle Aged
  • P-Selectin / drug effects*
  • P-Selectin / metabolism
  • Partial Thromboplastin Time
  • Prothrombin / antagonists & inhibitors
  • Thrombin / drug effects*
  • Thrombin / metabolism
  • Thrombin Time
  • Time Factors

Substances

  • Anticoagulants
  • Enoxaparin
  • Factor Xa Inhibitors
  • P-Selectin
  • Prothrombin
  • Factor IIa
  • Thrombin