{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T12:46:34Z","timestamp":1758631594969,"version":"3.40.5"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T00:00:00Z","timestamp":1660262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Low\u2010molecular\u2010weight heparin enoxaparin is widely used in pharmacological thromboprophylaxis after coronary artery bypass grafting (CABG). The aim of this study was to compare anti\u2010factor X activity (anti\u2010Xa) levels when the thromboprophylactic dose of enoxaparin was provided after CABG, with two different administration routes: continuous intravenous infusion (CIV) and subcutaneous bolus (SCB) injection. We hypothesized that the current standard method of SCB administration might lead to lower anti\u2010Xa levels than recommended in other patient groups, due to reduced bioavailability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective, randomized, controlled clinical trial, 40 patients scheduled for elective CABG were randomized to receive 40\u2009mg of enoxaparin per day either as CIV or SCB for 72\u2009h. Enoxaparin was initiated 6\u201310\u00a0h after CABG. Anti\u2010Xa levels were measured 12\u201314 times during the study period. The primary outcome, that is, the maximum anti\u2010Xa concentration over 0\u201324\u2009h (<jats:italic>C<\/jats:italic><jats:sub>max0\u201324h<\/jats:sub>), was calculated from these measured values. Secondary outcomes were <jats:italic>C<\/jats:italic><jats:sub>max25\u201372h<\/jats:sub> and the trough concentration of anti\u2010Xa after 72\u2009h of enoxaparin initiation (<jats:italic>C<\/jats:italic><jats:sub>72h<\/jats:sub>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty patients were randomized to the CIV\u2010group and 19 to the SCB\u2010group. The median anti\u2010Xa <jats:italic>C<\/jats:italic><jats:sub>max0\u201324h<\/jats:sub> was significantly lower in the CIV\u2010group than in the SCB\u2010group: 0.15 [interquartile range (IQR) 0.13\u20130.19] IU\/ml versus 0.25 (IQR 0.18\u20130.32) IU\/ml, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.005. The median anti\u2010Xa <jats:italic>C<\/jats:italic><jats:sub>max25\u201372h<\/jats:sub> was 0.12 (IQR, 0.1\u20130.17) IU\/ml versus 0.23 (IQR 0.19\u20130.31) IU\/ml, respectively, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.005. At 72\u2009h, there was no difference between the groups in their anti\u2010Xa levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this low\u2010risk CABG patient population, SCB administration of a thromboprophylactic dose of enoxaparin provided anti\u2010Xa levels that are considered sufficient for thromboprophylaxis in other patient groups. CIV administration resulted in lower anti\u2010Xa levels compared to the SCB route.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14122","type":"journal-article","created":{"date-parts":[[2022,7,31]],"date-time":"2022-07-31T04:14:07Z","timestamp":1659240847000},"page":"1083-1090","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Anti\u2010factor X activity levels with continuous intravenous infusion and subcutaneous administration of enoxaparin after coronary artery bypass grafting: A randomized clinical trial"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3088-827X","authenticated-orcid":false,"given":"Maria K.","family":"Parviainen","sequence":"first","affiliation":[{"name":"Tampere University Heart Hospital Tampere  Tampere 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