Abstract Number: PB1015
Meeting: ISTH 2022 Congress
Theme: Coagulation and Natural Anticoagulants » Critical Care and Perioperative
Background: Bleeding is the most feared complication during oral anticoagulant therapy but for direct oral anticoagulant, biological assessment of reversion is still unclear.
Aims: The aim of this study is to assess, during major bleeding under oral anticoagulants, the effect of reversal therapy on hemostasis parameters using the Quantra® system.
Methods: We conducted a pilot study on anticoagulated patients (VKA, or direct oral anticoagulants (DOACs): dabigatran or apixaban) admitted to an emergency department for a life-threating bleeding. Routine hemostasis parameters and those assessed by the Quantra are realized before and 30 min after the end of the reversal therapy.
Results: 5 patients were included: 3 patients on Apixaban therapy, 1 patient on dabigatran therapy and 1 patient on VKA therapy. Apixaban was reversed by 48,13+/-3,23 UI/Kg of 4F-PCC, dabigatran by idarucizumab (5g) and VKA therapy by 25 UI/kg of 4F-PCC.
Regarding Quantra parameters, an increase value of Coagulation Time (CT) and Stiffness of the clot (CS) was found after reversal therapy for patients on apixaban therapy whereas for patients on dabigatran or VKA therapy we found a decrease of CT. Regarding routine hemostasis parameters, as expected, we observed an increase rate of factor II, V and X after reversal therapy by 4F-PCC, a decrease of quick time (QT) regarding all anticoagulants agent and an increase of ACT for apixaban but a decrease of dabigatran or VKA.
Conclusion(s): If the Quantra analyzer could be of help for the management of major bleeding under oral anticoagulant agent in an emergency room, a larger multicenter study is needed to better understand the effect of reversal therapy on anticoagulant agent and more specially on DOACs.
To cite this abstract in AMA style:
Teissandier D, Lucchini C, Bouillon-Minois J, Schmidt J, Sinegre T, Morand c, Lebreton A, Moustafa F. Assessment of Quantra Analyzer on life-threating bleeding under oral anticoagulants agents: a pilot study [abstract]. https://abstracts.isth.org/abstract/assessment-of-quantra-analyzer-on-life-threating-bleeding-under-oral-anticoagulants-agents-a-pilot-study/. Accessed March 21, 2024.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/assessment-of-quantra-analyzer-on-life-threating-bleeding-under-oral-anticoagulants-agents-a-pilot-study/