Anti-Xa Assay Correlation to the Efficacy and Safety of Enoxaparin in the Treatment of Pulmonary Embolism
Anti-Xa Assay Correlation to the Efficacy and Safety of Enoxaparin in the Treatment of Pulmonary Embolism
The aim of the present study is to monitor anticoagulant therapy by anti-Xa assay and
 correlate its level to the efficacy and safety of enoxaparin in the treatment of pulmonary
 embolism.
This prospective randomized trial was conducted on 42 patients 18 years of age or older in
 ICU diagnosed to have pulmonary embolism and confirmed by the presence of intraluminal
 filling defect in CT pulmonary angiography and treated with subcutaneous enoxaparin 1
 mg/kg/12 hours. The study was conducted from August 2013 to September 2016.

 All the patients were examined daily over a period of 4 weeks for symptoms and signs of
 recurrent pulmonary embolism (recurrent pulmonary embolism was diagnosed if the repeat CT
 angiography revealed a new sudden arterial branch cutoff or a new intraluminal filling defect
 that was not present on the first angiogram), Platelet count (patients with platelet count
 less than 50,000/mm3 or those with bleeding and platelet count between 50,000 and 100,000/mm3
 are considered having severe thrombocytopenia), bleeding (defined as major overt bleeding
 requiring blood transfusion > 2 units or marked hemoglobin drop > 2 gm/dl or if the bleeding
 was intracranial or retroperitoneal) and death (defined as all deaths occurring within the 4
 weeks of the study) , Then the results were correlated to anti-Xa assay.
Inclusion Criteria:

 -  Patients in ICU and diagnosed to have pulmonary embolism and confirmed by the presence
 of intraluminal filling defect in CT pulmonary angiography and treated with
 subcutaneous enoxaparin 1 mg/kg/12 hours.

 Exclusion Criteria:

 -  Patients who underwent thrombolysis, embolectomy or if they are unfit for
 anticoagulant therapy because of major bleeding or thrombocytopenia (a platelet count
 below 100,000 per cubic millimeter). Patients were also excluded if they had impaired
 kidney function with a serum creatinine level above 2 mg/dl or uncontrolled
 hypertension (blood pressure > 160/100 mmHg).