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

Jacqueline Saw, Dean J. Kereiakes, Kenneth W. Mahaffey, Robert J. Applegate, Gregory A. Braden, Bruce N. Brent, Bruce R. Brodie, James B. Groce, Glenn N. Levine, Fred Leya, David J. Moliterno

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


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 ≤160 s corresponded to anti-Xa level of ≤0.5 IU/ml in 95% (188/197) of patients. A CWB ENOX time ≥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.

Original languageEnglish
Pages (from-to)301-306
Number of pages6
JournalThrombosis Research
Issue number5-6
StatePublished - 2003


  • Anti-Xa activity
  • Clotting time
  • Enoxaparin

ASJC Scopus subject areas

  • Hematology


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