34
Treatment
Table 8. Anticoagulant Dosing During PCI*
Drug
Patient Has Received
Previous Anticoagulant
Therapy
Patient Has Not Received
Previous Anticoagulant
Therapy
Dosing of Parenteral Anticoagulants During PCI
UFH Additional UFH as needed
(e.g., 2000–5000 U) to achieve
an ACT of 250–300 s*
70–100 U/kg initial bolus to
achieve target ACT of 250–300 s*
Enoxaparin • For previous treatment with
enoxaparin, if the last SC
dose was administered 8–12
hours earlier or if only 1 SC
dose of enoxaparin has been
administered, an IV dose
of 0.3 mg/kg of enoxaparin
should be given
• If the last SC dose was
administered within the
previous 8 hours, no additional
enoxaparin should be given
0.5–0.75 mg/kg IV bolus
Bivalirudin • For patients who have received
UFH, repeat ACT
• If ACT is not in therapeutic
range, then give 0.75 mg/kg IV
bolus, then 1.75 mg/kg/h IV
infusion
0.75 mg/kg bolus, 1.75 mg/kg/h
IV infusion
Argatroban 200 µg/kg IV bolus, then 15
µg/kg/min IV infusion
350 µg/kg, then 15 µg/kg/min IV
infusion
* Target ACTs for UFH dosing shown for HemoTec (GmbH, Switzerland) or I-Stat (Abbott)
device. For Hemochron ACT (Werfen) devices, ACT goals are 50 s higher. In the case of
CTO or ACS, consider higher target ACT. If IV glycoprotein IIb/IIIa receptor inhibitor is
planned, target ACT 200–250 s.
