ASSESSMENT OF ANTICOAGULATION USING ACTIVATED CLOTTING TIME (ACT) IN PATIENTS RECEIVING ENOXAPARIN AND HEPARIN DURING PERCUTANEOUS CORONARY INTERVENTION (PCI).

http://doi.org/10.46536/jpumhs/2023/13.01.381

Abstract

ABSTRACT

Introduction: The standard of therapy for some patients with coronary artery disease,

particularly those who arrive with acute coronary syndrome, is percutaneous coronary

intervention (PCI) (ACS). To avoid thrombotic problems during PCI, the American College of

Cardiology (ACC) and the European Society of Cardiology (ESC) advise using anticoagulation

in addition to dual antiplatelet treatment (DAPT). Objective: to assess how enoxaparin affects

the active clotting time (ACT) and how UFH reacts to enoxaparin. Material and methods: The

intervention cardiology department at Hayatabad Hospital Complex in Peshawar did this crosssectional descriptive research from June 1 to April 30, 2022. By using a non-probability

sequential sampling strategy, patients were included. After a thorough history, examination, and

informed permission, all patients 18 years old having PCI were included in the research.

Individuals with known blood dyscrasias or thrombophilia, as well as those who had received

anticoagulation within the previous 12 hours or just prior, were excluded from the trial. Results:

Among the patients who received heparin, ACT increased from 104.76±27.31 seconds to

448.34±169.11 (t-statistic=13.750, 95% CI: 293.9540 to 393.2060, p: <0.01) whereas among

patients who received enoxaparin, this number increased from 99.58±27.68 seconds to

334.37±166.45 seconds (t statistic=6.817, 95% CI: 165.4597 to 304.1203, p:<0.01). The postanticoagulation ACT was significantly higher in the heparin group compared to enoxaparin

group i.e. 448.34±169.11 and 334.37±166.45 seconds respectively (t statistic=2.700, 95% CI:

29.7639 to 198.1661, p:<0.01). Conclusion: After taking i.v. enoxaparin and heparin, the ACT is

extended in patients for around 15 minutes, and this prolongation may help track the

anticoagulant action of the medication. Moreover, in this situation, ACT levels and ENOX

clotting times are correlated. A bigger experiment will be necessary to determine the association

between ACT level and clinical effectiveness utilising intravenous enoxaparin.