EFFECTIVENESS AND SAFETY OF ENOXAPARIN AS ANTICOAG- ULANT IN PATIENTS UNDERGOING ELECTIVE PERCUTANEOUS CORONARY INTERVENTION FOR STABLE CORONARY ARTERY DISEASE: FIVE-YEARS EXPERIENCE OF A SINGLE CENTER

Abstract

Objective: To determine the effectiveness and safety of enoxaparin as antico- agulant in patients undergoing elective percutaneous coronary intervention for stable coronary artery disease.

Methodology: This study was conducted at the Department of Department of Cardiology, Hayat Abad Medical Complex, Peshawar, from March 2013 to De- cember 2017. All patients who underwent elective percutaneous coronary inter- vention (PCI) for stable coronary artery disease were included in the study. We retrospectively analysed our data for short term outcome of efficacy and safety with use of enoxaparin as procedural anticoagulant. The dose of enoxaparin used was 0.75-1mg/kg. Sheath removal with manual compression haemostasis was performed 6 hours after the femoral route and within first hour after the radial procedure. Data were analysed by SPSS version 23.

Results: A total of 3190 elective PCIs with enoxaparin as anticoagulant were performed in the study period. Mean age of the patients was 57.48 +6.9 years and 70% were males. Among the efficacy end points, major adverse cardio- vascular events occurred in 1.4%. Mortality of any cause was 0.34% in the total patients studied. Urgent repeat revascularization for acute stent thrombosis was performed in 0.4% of patients. Acute MI and ischemic strokes occurred in 0.50% and 0.15% of patients respectively. Among the safety end points, major bleeding occurred in 0.37% of patients. Intracerebral bleeds and coronary per- forations were 0.06% each. Minor bleeding that did not cause any significant morbidity were in 2.85% patients.

Conclusion: Enoxaparin in a weight based regimen can be used effectively and safely for percutaneous coronary interventions for stable coronary artery dis- ease.