TY - JOUR
T1 - Combination enoxaparin and abciximab therapy during percutaneous coronary intervention
T2 - "NICE guys finish first"
AU - Kereiakes, Dean J.
AU - Fry, Edward
AU - Matthai, William
AU - Niederman, Alan
AU - Barr, Lawrence
AU - Brodie, Bruce
AU - Zidar, James
AU - Casale, Paul
AU - Christy, George
AU - Moliterno, David
AU - Lengerich, Rose
AU - Broderick, Thomas
AU - Shimshak, Thomas
AU - Cohen, Marc
PY - 2000/2
Y1 - 2000/2
N2 - Data from randomized clinical trials support the administration of both enoxaparin and platelet glycoprotein IIb/IIIa blockade to patients who present with non-ST segment evaluation acute coronary syndromes. Enoxaparin does not activate platelets, has a more predictable dose response that facilitates weight-adjusted dosing and may have enhanced antithrombotic (increased anti-Xa activity) and safety (reduced anti-IIa activity) properties when compared with unfractionated heparin. Abciximab administration during percutaneous coronary intervention reduces the incidence of ischemic adverse outcomes and may improve survival in long-term follow-up. The preliminary experience with combining abciximab and intravenous enoxaparin during percutaneous coronary intervention in the NICE-4 Trial demonstrates a low incidence of minor/major bleeding (TIMI definition) and transfusion and infrequent major cardiac events to 30 days follow-up. Future algorithms to facilitate the transition of patients from the clinical service who have received subcutaneous administration of enoxaparin to the cardiac catheterization laboratory prior to percutaneous coronary intervention are forthcoming and will provide seamless integration of "optimal" adjunctive pharmacology through the course of hospitalization for patients with non-ST elevation acute coronary syndromes.
AB - Data from randomized clinical trials support the administration of both enoxaparin and platelet glycoprotein IIb/IIIa blockade to patients who present with non-ST segment evaluation acute coronary syndromes. Enoxaparin does not activate platelets, has a more predictable dose response that facilitates weight-adjusted dosing and may have enhanced antithrombotic (increased anti-Xa activity) and safety (reduced anti-IIa activity) properties when compared with unfractionated heparin. Abciximab administration during percutaneous coronary intervention reduces the incidence of ischemic adverse outcomes and may improve survival in long-term follow-up. The preliminary experience with combining abciximab and intravenous enoxaparin during percutaneous coronary intervention in the NICE-4 Trial demonstrates a low incidence of minor/major bleeding (TIMI definition) and transfusion and infrequent major cardiac events to 30 days follow-up. Future algorithms to facilitate the transition of patients from the clinical service who have received subcutaneous administration of enoxaparin to the cardiac catheterization laboratory prior to percutaneous coronary intervention are forthcoming and will provide seamless integration of "optimal" adjunctive pharmacology through the course of hospitalization for patients with non-ST elevation acute coronary syndromes.
KW - Activated clotting time
KW - Platelet glycoprotein IIb/IIIa blockade
KW - Unfractionated heparin
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M3 - Article
C2 - 10731289
AN - SCOPUS:18744418112
SN - 1042-3931
VL - 12
SP - 1A-5A
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - SUPPL. A
ER -