Abstract Number: PB0421
Meeting: ISTH 2021 Congress
Background: Direct oral anticoagulants (DOACs) are widely used for the prevention and treatment of thromboembolic events and are known to impact coagulation assays and enhance FX-dependent fibrinolysis and plasmin generation.
Simultaneous assessment of the coagulation and fibrinolysis processes could facilitate the global understanding of the pharmacodynamics of DOACs. We have previously reported the performance of the FibWave to assess the impact of DOACs on the clot formation process. In this study the FibWave has been adapted in order to measure both the clot formation and fibrinolysis processes simultaneously.
Aims: To evaluate the suitability of the FibWave for assessing the impact of DOACs on coagulation and fibrinolysis simultaneously.
Methods: DOACs were spiked at final concentrations from 0 to 250 ng/mL in normal pooled plasma. The fibrin clot formation and the fibrinolysis were measured on the FibWave using a mixture of tissue factor, phospholipids and tissue plasminogen activator (tPA).
Results: In absence of tPA, the most influenced parameters in clot formation were the FW-Max2, FW-Min2 and FW-Ttpeak for factor Xa (FXa) inhibitors and FW-Ttpeak for dabigatran.
The presence of tPA did not impact significantly the parameters of the clot formation. FXa inhibitors showed a reduction of maximum fibrinolysis velocity (|FW-Min1|) while dabigatran showed a prolongation of fibrinolysis time (FW-TFib). The time length between fibrinolysis and coagulation velocities (FW-TFib – Ttpeak) was reduced for all anticoagulants (Figure 1).
Conclusions: Thanks to its capacity to assess coagulation and fibrinolysis, the FibWave parameters could be useful for understanding global haemostatic potential and evaluating the bleeding risk from the perspective of fibrinolysis.
To cite this abstract in AMA style:Evrard J, Maloteau V, Dogné JM, Douxfils J. Assessment of DOACs Effect on Clot Formation and Fibrinolysis Using the FibWave [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/assessment-of-doacs-effect-on-clot-formation-and-fibrinolysis-using-the-fibwave/. Accessed December 7, 2021.
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