Abstract
OBJECTIVE: Anticoagulation therapy, including enoxaparin, is crucial for preventing blood clots in patients at risk for thromboembolic events. However, due to enoxaparin's enhanced renal elimination, proper prophylactic dosing may be challenging. This exploratory study evaluates antifactor X(a) levels in patients with augmented renal clearance (ARC) receiving enoxaparin prophylaxis. METHODS: Forty patients aged 18 years or older receiving 40 mg of enoxaparin for deep vein thrombosis prophylaxis with a high ARC score were observed. ARC was confirmed by creatinine clearance exceeding 130 mL/min. Exclusion criteria included various conditions impacting hemostasis. The objective was to assess antifactor X(a) levels 4 h after the fourth dose of enoxaparin administration using a chromogenic assay. FINDINGS: The mean ± standard deviation of the antifactor X(a) levels was 0.28 ± 0.21. A significant number of participants (65%) had suboptimal antifactor X(a) levels. CONCLUSION: The prophylactic use of enoxaparin in patients with ARC may result in insufficient antifactor X(a) levels. Although the mean levels were within the target range, many individuals did not reach the target level. Healthcare providers should consider renal function and ARC when prescribing enoxaparin to prevent thromboembolic events.