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Effect and Stability of Dabigatran on Thrombin Generation over a Year in Elderly Patients with Atrial Fibrillation

1University of São Paulo Medical School - Coagulation Laboratory - Hospital das Clínicas, Sao Paulo, Brazil, 2University of São Paulo Medical School - Interdisciplinary Medicine in Cardiology - Heart Institute (InCor), Sao Paulo, Brazil, 3Stago, Sao Paulo, Brazil

Abstract Number: PB0361

Meeting: ISTH 2021 Congress

Theme: Diagnostics and OMICs » Laboratory Diagnostics

Background: Direct oral anticoagulants are first options for thromboembolism prevention in non-valvular atrial fibrillation. Little is known about their effect on thrombin generation (TG) parameters and there is no information about the stability of anticoagulation effect during treatment.

Aims: The first aim of this study is to analyze the effect of dabigatran on TG parameters and then to assess the stability of the identified parameters over time.

Methods: Our local ethics committee approved the protocol. We included 25 patients with atrial fibrillation and age above or equal to 70 yrs. scheduled to start dabigatran treatment. Blood samples for TG assay in automated system (ST GENESIA) were collected before (time A), 3 months (time B) and 12 months(time C) after dabigatran start. Comparisons between TG parameters in time A and C showed the effect of dabigatran, and comparisons between times B and C showed stability or the effect.

Results: Dabigatran significantly prolonged the Lag Time: 3.30 ± 1.44 vs 1.67 ±0.49, p<0.001, and the Time to Peak: 4.41 ±1.18 vs 3.02 ±0.75, p<0.001. There was no significant effect on Thrombin Peak ( 259.79 ±98.86 vs 297.82 ±69.05, p=0.06) or on Endogenous Thrombin Potential (950.68 ±365.28 vs 286.82, p= 0.012). The comparisons of LagTime ( 3.36 ±1.22 vs 3.30±1.14, p=0.98) and Time to Peak  (4.48±1.29 vs 4.41±1.18 and P=0.99) between 3 and 12 months showed impressive stability (Figure1).

Comparison between LagTime and Time to Thrombin Peak in 3 and 12 months of dabigatran therapy.

Conclusions: Dabigatran increased the Lag-Time and Time to Thrombin Peak in the TG ST-GENESIA assay and these effects remained impressively stable over the time.

To cite this abstract in AMA style:

Rocha TR, Pastana A, Villaça P, D`Amico E, Yu P, Magalhães I, Cardozo FA, Lustosa G, Franco L, Caramelli B, Calderaro D. Effect and Stability of Dabigatran on Thrombin Generation over a Year in Elderly Patients with Atrial Fibrillation [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/effect-and-stability-of-dabigatran-on-thrombin-generation-over-a-year-in-elderly-patients-with-atrial-fibrillation/. Accessed January 23, 2022.

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