Dalteparin in combination with abciximab during percutaneous coronary intervention

Dean J. Kereiakes, Neal Kleiman, Edward Fry, Grace Mwawasi, Rose Lengerich, Kelly Maresh, Mary Lynn Burkert, Joseph W. Aquilina, Michael DeLoof, Thomas M. Broderick, Thomas M. Shimshak

Research output: Contribution to journalArticle

88 Scopus citations

Abstract

Background: Despite proved efficacy for either dalteparin or platelet glycoprotein IIb/IIIa blockade in improving clinical outcomes of patients with non-ST-segment elevation acute coronary syndromes, algorithms guiding concomitant therapy with these agents have not been devised. The purpose of this study was to assess anticoagulant effect and clinical safety for several dose regimens of dalteparin administered in combination with abciximab during percutaneous coronary intervention (PCI). Methods and Results: Patients undergoing PCI with standard dose abciximab received dalteparin as follows: 120 IU/kg subcutaneously (SQ) to a maximum of 10,000 U if ≤8 hours before PCI (n = 3); for PCI 8-12 hours after the SQ dose, an additional 40 IU/kg intravenously (IV) was administered (n = 1); for PCI > 12 hours after SQ dalteparin or with no prior dalteparin therapy, random allocation to 40 (n = 27) or 60 (n = 28) IU/kg IV during PCI was performed. Those patients who received 60 IU/kg of dalteparin IV had a lower incidence of procedural thrombosis (0% vs 11.1%, P < .01), more consistent an tithrombotic effect (anti-factor Xa activity) and a similar incidence of major bleeding (3.7% vs 2.6%) compared with patients who received 40 IU/kg of intravenous dalteparin. Conclusions: Dalteparin 60 IU/kg IV appears to be safe and effective when administered in conjunction with abciximab for percutaneous coronary intervention.

Original languageEnglish (US)
Pages (from-to)348-352
Number of pages5
JournalAmerican Heart Journal
Volume141
Issue number3
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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