Use of enoxaparin in patients undergoing percutaneous coronary intervention.

Recent large-scale trials have demonstrated superior clinical outcomes associated with the use of enoxaparin in patients with acute coronary syndromes and have led to its incorporation into the recent American College of Cardiology/American Heart Association guidelines for the management of patients with unstable angina/non-ST elevation myocardial infarction. Despite clinical trial evidence, questions arise as to how best to manage patients who have received subcutaneous enoxaparin who may then require subsequent coronary intervention. We present four potential management strategies for handling the transition of these patients to the catheterization laboratory and specific dosing recommendations for the use of enoxaparin in these circumstances.