Evaluation of a novel point-of-care enoxaparin monitor with central laboratory anti-Xa levels.


Journal Article

BACKGROUND: Measurement of enoxaparin's anticoagulant activity has been limited to specialized coagulation laboratories and has been impractical for areas needing rapid results, such as during coronary angioplasty. A new point-of-care device, Rapidpoint ENOX, was recently developed to measure clotting times with enoxaparin use. OBJECTIVES: To correlate ENOX times with anti-Xa levels among patients receiving enoxaparin. METHODS: A total of 166 patients receiving enoxaparin for the prevention of deep venous thrombosis or as treatment during acute coronary syndromes or angioplasty were prospectively studied. Citrated and non-citrated whole-blood (CWB and NCWB) samples were obtained at baseline and peak enoxaparin activity. ENOX times were measured with whole-blood, and the Stachrom anti-Xa assay was performed on the plasma from the remainder of the samples. The Pearson correlation coefficient was used to assess the relationship between these two assays. RESULTS: There was a strong linear correlation between the ENOX times and the anti-Xa activities for both CWB (r=0.89, p<0.001) and NCWB (r=0.82, p<0.001) when considering all 332 samples (baseline and peak). When baseline samples were excluded, the correlation remained strong for CWB ENOX times and anti-Xa levels (r=0.84, p<0.001), but was only moderate for NCWB (r=0.73, p<0.001). A CWB ENOX time of /=200 s corresponded to anti-Xa levels >/=0.8 IU/ml in 96% (93/96) of patients. CONCLUSIONS: Rapidpoint ENOX times correlate strongly to anti-Xa activities measured by the Stachrom Heparin Assays for citrated whole-blood samples. This novel test can be used for rapid bedside measurements of enoxaparin anticoagulant activity.

Full Text

Cited Authors

  • Saw, J; Kereiakes, DJ; Mahaffey, KW; Applegate, RJ; Braden, GA; Brent, BN; Brodie, BR; Groce, JB; Levine, GN; Leya, F; Moliterno, DJ

Published Date

  • January 2003

Published In

Volume / Issue

  • 112 / 5-6

Start / End Page

  • 301 - 306

PubMed ID

  • 15041274

Pubmed Central ID

  • 15041274

Electronic International Standard Serial Number (EISSN)

  • 1879-2472

International Standard Serial Number (ISSN)

  • 1879-2472

Digital Object Identifier (DOI)

  • 10.1016/j.thromres.2004.01.006


  • eng