Whole blood coagulation assays ROTEM and T-TAS to monitor dabigatran treatment
| Autor: | Anna Ågren, Håkan Wallén, V. Taune, Anna M. Wintler, Agneta Wikman, Mika Skeppholm, Rickard E. Malmström, Gunilla Gryfelt, Carolina Sjövik |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Whole Blood Coagulation Time Point-of-Care Systems 030204 cardiovascular system & hematology Antithrombins Dabigatran 03 medical and health sciences 0302 clinical medicine Atrial Fibrillation medicine Humans 030212 general & internal medicine Thrombus Blood Coagulation Aged Whole blood medicine.diagnostic_test business.industry Atrial fibrillation Hematology Middle Aged medicine.disease Thromboelastography Thrombelastography Thromboelastometry Clotting time Anesthesia Hemostasis Female Blood Coagulation Tests Drug Monitoring business medicine.drug |
| Zdroj: | Thrombosis Research. 153:76-82 |
| ISSN: | 0049-3848 |
| DOI: | 10.1016/j.thromres.2017.03.018 |
| Popis: | A rapid and reliable assessment of the dabigatran effect is desirable in dabigatran treated patients with uncontrolled bleeding or before acute surgery.To evaluate how the viscoelastic point-of-care test Rotational thromboelastometry (ROTEM) and Total Thrombus-formation system (T-TAS), which studies thrombus formation under flowing conditions, correlate with dabigatran concentrations in patients with atrial fibrillation (AF).ROTEM using the reagents In-tem, Ex-tem, Fib-tem or low tissue factor concentration (TF), and T-TAS with the AR-chip (shear rate 600sMedian plasma dabigatran concentrations at trough were 86ng/mL (29-150) and post-dose (2.8h after ingestion) 175ng/mL (67-490). The ROTEM clotting time (CT) correlated strongly with dabigatran concentrations when activated with the reagents Ex-tem (r=0.92, p0.01) and Fib-tem (r=0.93, p0.01), while with In-tem and low TF the correlation was weaker (r=0.72 and r=0.36, p0.01). There were significant but weaker correlations also between dabigatran concentrations and T-TAS variables (r-values 0.39-0.41, p0.01), aPTT (r=0.70, p0.01) and PT-INR (r=0.43, p0.01) respectively.ROTEM Ex-tem and Fib-tem CT shows a strong correlation with dabigatran concentrations in real-life AF-patients, and results are obtained within minutes. This could make ROTEM useful in acute situations. T-TAS detect differences in hemostasis caused by dabigatran, but the relationships to plasma concentrations of dabigatran are weaker than for ROTEM CT with the settings used in this study. |
| Databáze: | OpenAIRE |
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