In such patients, as well as in patients who have received only 1 subcutaneous dose of enoxaparin, the addition of enoxaparin (0.3 mg/kg IV) at the time of PCI provides an additional degree of antico- agulation and has become standard practice.648,661 664 Pa- tients who undergo PCI 12 hours after the last subcuta- neous dose are usually treated with full-dose de novo anticoagulation using an established regimen (eg, full-dose UFH or bivalirudin). 5.7.4.4. Bivalirudin and Argatroban: Recommendations Class I 1. For patients undergoing PCI, bivalirudin is useful as an anticoagulant with or without prior treatment with UFH.625,637 645 (Level of Evidence: B) Table 12. Dosing of Parenteral Anticoagulants During PCI Drug Patient Has Received Prior Anticoagulant Therapy Patient Has Not Received Prior Anticoagulant Therapy UFH IV GPI planned: additional UFH as needed (eg, 2000 to 5000 U) to achieve an ACT of 200 to 250 s IV GPI planned: 50 to 70 U/kg bolus to achieve an ACT of 200 to 250 s No IV GPI planned: additional UFH as needed (eg, 2000 to 5000 U) to achieve an ACT of 250 to 300 s for HemoTec, 300 to 350 s for Hemochron No IV GPI planned: 70 to 100 U/kg bolus to achieve target ACT of 250 to 300 s for HemoTec, 300 to 350 s for Hemochron Enoxaparin For prior treatment with enoxaparin, if the last SC dose was administered 8 to 12 h 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. 0.5 to 0.75 mg/kg IV bolus If the last SC dose was administered within the prior 8 h, no additional enoxaparin should be given. 