Anti-Xa Levels in Morbidly Obese Patients Using Apixaban or Rivaroxaban, Before and After Bariatric Surgery
| Autor: | Bart Witteman, Houshang Monajemi, Marcel Hovens, Matthijs van Luin, Thom Kok, Hans de Boer |
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| Rok vydání: | 2021 |
| Předmět: |
Post bariatric surgery
medicine.medical_specialty Pyridones Endocrinology Diabetes and Metabolism Gastric Bypass Administration Oral Morbidly obese Gastroenterology Therapeutic index Rivaroxaban Internal medicine Medicine Humans In patient Longitudinal Studies Retrospective Studies Nutrition and Dietetics business.industry Anticoagulants Perioperative Heparin Low-Molecular-Weight Obesity Morbid Cross-Sectional Studies Pyrazoles Surgery Apixaban business Body mass index medicine.drug Factor Xa Inhibitors |
| Zdroj: | Obesity surgery. 32(3) |
| ISSN: | 1708-0428 |
| Popis: | Background Despite limited evidence about the efficacy and safety of anticoagulation in patients post bariatric surgery, both vitamin K antagonists (VKA) and direct-acting oral anticoagulants (DOACs) are commonly prescribed. Aim To evaluate plasma anti-Xa levels of DOACs in morbidly obese (MO) patients before and after a Roux-en-Y gastric bypass (RYGB) procedure. Patients and methods Retrospective, cross-sectional, and longitudinal study of anti-Xa activity of apixaban or rivaroxaban in MO patients (N = 41). Results Preoperative analysis of plasma anti-Xa levels were within the normal range in patients using apixaban (n = 29; body mass index [BMI] 44.5 ± 5.1 kg/m2) as well as those using rivaroxaban (n = 12; BMI 42.6 ± 5.9 kg/m2). Postoperative anti-Xa levels of apixaban were all within the therapeutic range, whereas anti-Xa levels of rivaroxaban were subtherapeutic in nine out of 14 (64%) patients. Perioperative longitudinal follow-up in patients using apixaban (n = 18) showed no significant change in anti-Xa levels after RYGB. Conclusion Plasma anti-Xa levels of apixaban in MO patients remained within the therapeutic range up to a body weight of 144 kg. In patients using rivaroxaban, no statistically significant relation between anti-Xa levels and bodyweight was found. After RYGB, plasma anti-Xa levels of apixaban were unaffected, whereas plasma anti-Xa levels of rivaroxaban tended to become subtherapeutic. |
| Databáze: | OpenAIRE |
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