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. 2008 Winter;13(4):175-8.

Anti-Xa activity of enoxaparin and nadroparin in patients with acute coronary syndrome

Petr Ostadal  1 , David Alan, Jiri Vejvoda, Jitka Segethova, Andreas Kruger
Affiliations

Anti-Xa activity of enoxaparin and nadroparin in patients with acute coronary syndrome

Petr Ostadal et al. Exp Clin Cardiol. 2008 Winter.

Abstract

Background: Clinical studies have clearly revealed that low-molecular-weight heparins (LMWHs) are an effective alternative to unfractionated heparin in the therapy of acute coronary syndrome (ACS); however, data on the comparison of different LMWHs are sparse.

Aim: To compare the inhibition of coagulation factor Xa by enoxaparin and nadroparin in the therapy of ACS.

Methods: Thirty-eight consecutive patients with ACS were randomly assigned to enoxaparin (group E, n=18) or nadroparin (group N, n=20) in the recommended dose. Anti-Xa activity was measured 3 h after administering the first dose of LMWH.

Results: Baseline demographics (age, sex) and clinical (type of ACS, pain-to-door time, elevation of troponin, percutaneous coronary intervention performed, smoking status, and history of diabetes, hypertension and hyperlipoproteinemia) characteristics were similar in both groups. Anti-Xa activity was significantly higher in group E than in group N (0.65+/-0.05 U/mL versus 0.30+/-0.03 U/mL; P<0.001). Moreover, the therapeutic target (0.5 U/mL to 0.8 U/mL) was achieved in 66.7% of patients in group E; on the other hand, effective therapy was observed in 10.0% of patients in group N (P<0.001).

Conclusions: The results of the present study demonstrate a highly significant difference in anti-Xa activity of enoxaparin and nadroparin in their recommended dosing regimens, in the therapy of ACS 3 h after subcutaneous administration; the anticoagulant effect of enoxaparin was markedly stronger than that of nadroparin.

Keywords: Acute coronary syndrome; Enoxaparin; Factor Xa; Heparin; Nadroparin.

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Figures

Figure 1)
Figure 1)
Study design. ACS Acute coronary syndrome; ASA Acetylsalicylic acid; IV Intravenous; LMWH Low-molecular-weight heparin; PCI Percutaneous coronary intervention; SC Subcutaneous UFH Unfractionated heparin
Figure 2)
Figure 2)
Anti-Xa levels in study subjects 3 h after administration of enoxaparin and nadroparin
Figure 3)
Figure 3)
Achievements of target anti-Xa level 3 h after administration of low-molecular-weight heparin (enoxaparin, nadroparin). Target values of anti-Xa anticoagulant therapy range from 0.5 U/mL to 0.8 U/mL
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