Role of enoxaparin resistance in recurrent chest pain in the intensive care unit

The Journal of International Medical Research
Aysem KayaZ Yigit

Abstract

To investigate the relationship between anticoagulation treatment and drug resistance in chest pain, levels of factor Xa residual activity were determined in patients seen in intensive care with recurrent chest pain and compared with levels in patients who had no ischaemic events during hospitalization. A total of 122 patients aged 18 - 75 years who were admitted to hospital with acute coronary syndrome and treated with enoxaparin were included. Of these, 62 patients had recurrent chest pain while hospitalized (group A) and 60 patients had an uneventful follow-up period (group B). Patients requiring primary percutaneous transluminal coronary angioplasty and/or treatment with glycoprotein IIb/IIIa inhibitors, and those with renal failure, a high risk of bleeding or receiving anti-inflammatory drugs were excluded from the study. Median levels (+/- interquartile range) of factor Xa residual activity were significantly higher in group A compared with group B (0.68 +/- 0.29 IU/ml versus 0.34 +/- 0.33 IU/ml). It is concluded that enoxaparin resistance, resulting in high levels of factor Xa residual activity, should be considered in patients with recurrent ischaemia.

References

Jan 23, 2003·Circulation·Shaun G GoodmanUNKNOWN Integrilin and Enoxaparin Randomized Assessment of Acute Coronary Syndrome Treatment (INTERACT) Trial Investigators
Feb 3, 2004·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Jack L MartinFrederique Bigonzi
May 19, 2005·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Maria BorentainPhilippe Lechat
Sep 8, 2006·The New England Journal of Medicine·Gilles MontalescotUNKNOWN STEEPLE Investigators
May 14, 2008·Current Pharmaceutical Design·Melanie Barantke, Hendrik Bonnemeier

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