Abstract Number: PB0580
Meeting: ISTH 2020 Congress
Background: Traditional coagulation tests are not sensitive for DOAC, and unacceptable to assess the degree of induced hypocoagulation. It is estimated that using of a chromogenic analysis anti-Xa-activity can evaluate the concentration of rivaroxaban/apixaban in blood plasma.
Aims: To assess laboratory efficacy and safety of therapy rivaroxaban/apixaban.
Methods: The subjects were 50 patients (18 men, 32 women), aged 26 to 86 years (Me = 49), of whom 27 received rivaroxaban, 23 – apixaban. It was collected the following information: gender, age, serum creatinine, DOAC type, dose, indication, time of last dose, thrombin generation assay (TGA). The concentration of rivaroxaban/apixaban were measured using anti-factor-Xa chromogenic assay. Statistics were performed using R.
Results: Indications for DOAC were DVT (42%), PE (28%), atrial fibrillation (28%), splenic artery thromboembolism – 2%. None of the patients had hemorrhagic and/or thrombotic complications during therapy. The range of DOAC concentrations ranged from 0 to 432.7 ng/ml (Me=105.24). Zero concentration of the drug was detected in 10%, which indicates a complete absence of adherence. Statistically significant differences in concentration were obtained between men and women (W = 340, p-value = 0.009707) and between working and non-working patients (W = 405, p-value = 0.03841). The median glomerular filtration rate (GFR) was 68.5 ml/min (Q1 = 59.25; Q2 = 89). The inverse relationship of medium strength between GFR and drug concentration was found (r = -0.36, p-value = 0.03544). The inverse relationship of medium strength between thrombin peak and drug concentration was found (r = -0.45, p-value = 0.0009).
Conclusions: 10% of patients showed a lack of laboratory adherence to therapy. A relationship was found between the concentration of DOAC and the sex and employment of patients.There are the relationship between the peak of thrombin/GFR and the concentration of DOAC.
To cite this abstract in AMA style:Vorobyeva N, Melnichuk E, Schapkov A, Shemiakina N. Laboratory Assessment of Efficacy and Safety of Direct Oral Anticoagulants in Real Clinical Practice [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/laboratory-assessment-of-efficacy-and-safety-of-direct-oral-anticoagulants-in-real-clinical-practice/. Accessed November 27, 2021.
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