Concomitant assessment of rivaroxaban concentration and its impact on thrombin generation
| Autor: | Jonathan Douxfils, François Mullier, Suzanne Zwaveling, Saartje Bloemen |
|---|---|
| Přispěvatelé: | RS: Carim - B01 Blood proteins & engineering, RS: CARIM School for Cardiovascular Diseases, Biochemie, RS: CARIM - R1.01 - Blood proteins & engineering, RS: Carim - B04 Clinical thrombosis and Haemostasis, RS: CARIM - R1.04 - Clinical thrombosis and haemostasis, RS: CARIM - R1 - Thrombosis and haemostasis, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Laboratoire de biologie clinique |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Plasma concentrations medicine.medical_specialty Thrombin generation Dilute Russell's viper venom time REVERSAL Direct factor Xa inhibitor 030204 cardiovascular system & hematology Gastroenterology WARFARIN Dabigatran 03 medical and health sciences Tissue factor 0302 clinical medicine Rivaroxaban Internal medicine medicine Humans FACTOR XA INCREASED RISK Platelet-poor plasma Prothrombin time Coagulation assays medicine.diagnostic_test PLASMA business.industry Thrombin Warfarin DABIGATRAN INHIBITOR Hematology HEMOPHILIA-A Coagulation 030220 oncology & carcinogenesis ATRIAL-FIBRILLATION DIRECT ORAL ANTICOAGULANTS Female business Factor Xa Inhibitors medicine.drug |
| Zdroj: | Thrombosis Research, 184, 8-15. Elsevier Science Thrombosis research, Vol. 184, p. 8-15 (2019) |
| ISSN: | 1879-2472 0049-3848 |
| Popis: | Background: Reliable assays to measure direct oral anticoagulant (DOAC) levels and their activity in critical situations are needed. Drug levels alone are not representative of the effect of DOACs on an individual's coagulation. We developed a technique that provides direct assessment of the global effect of rivaroxaban on the individual's coagulation in addition to plasma concentrations.Methods: DOAC concentrations were determined in fifty patients using rivaroxaban, with the new assay, Xross-CAT. The effect of rivaroxaban on coagulation (activity) was measured with thrombin generation (TG) in platelet poor plasma using 5 pM tissue factor on the same device. The levels were validated with the Biophen DiXal assay. The prothrombin time (PT) and dilute Russell viper venom time (dRVVT) were performed to estimate the effect on coagulation.Results: The variability of Xross-CAT was below 12%. Xross-CAT correlates well with Biophen DiXaI (r(s) = 0.885). The bias, determined by Bland-Altman analysis, was 4.9% and the Passing-Bablok equation was y = 1.1x - 2.1. The correlation of plasma levels with TG was moderate (ETP r(s) = -0.548; Peak r(s) = -0.559), as for the PT (r(s) = 0.739) and the dRVVT (r(s) = 0.692).Conclusions: Xross-CAT shows a good correlation with Biophen DiXaI that was previously confirmed to accurately assess rivaroxaban levels. Bleeding and thrombotic complications are not necessarily associated with drug levels and could be influenced by concomitant risk factors. The main benefit of Xross-CAT is that it can be performed simultaneously with thrombin generation, providing an overview of the global anticoagulation status of a patient in relation to circulating DOAC levels. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect