Abstract Number: PB0204
Meeting: ISTH 2020 Congress
Background: Direct oral anticoagulants (DOACs) are known to impact coagulation assays. Although many assays are available for the assessment of anticoagulants, limitations have been highlighted like the lack of sensitivity of routine assays or the need of specific calibrators. The thrombin generation assay (TGA) has a great potential for the monitoring of direct oral anticoagulants (DOACs). The FibWave is based on the evaluation of the kinetic of the fibrin clot formation which circumvents the limitations of the TGA without altering its capacity to assess the coagulation potential at the individual level.
Aims: The study aims
i) to demonstrate the relevance of the FibWave for assessing the anticoagulant activity and potency of the different DOACs,
ii) to compare the impact of DOACs on the FibWave and the calibrated automated thrombogram (CAT) system and
iii) to investigate the sensitivity of the different FibWave and CAT parameters.
Methods: DOACs were spiked at final concentrations ranging from 0 to 500 ng/mL in normal pooled plasma. Fibrin formation and thrombin generation were measured by FibWave and CAT methodologies, respectively. The coagulation was initiated using either inductor of the intrinsic or extrinsic pathway. The FibWave and CAT parameters were correlated to individual DOAC concentrations.
Results: Parameters of the FibWave and the CAT were more affected when the coagulation process was triggered by the extrinsic pathway (Figure 1). The most influenced FibWave parameters were the FW-Max2, the FW-Min2 and the FW-Ttpeak for factor Xa (FXa) inhibitors and FW-Ttpeak and FW-Max2 for dabigatran while the most influenced CAT parameters were the mVRI and the peak for FXa inhibitors and lag time for dabigatran.
Conclusions: Thanks to its ease of use and its capacity to assess to whole coagulation process, the FibWave could provide the clinicians with a global coagulation test, sensitive at relevant threshold concentrations with a reproducibility similar to the CAT.
To cite this abstract in AMA style:Evrard J, Morimont L, Siriez R, Dogné J-, Douxfils J. The FibWave, a New Sensitive and Relevant Tool for Analysing the fibrin Clot Formation: Comparison with the Calibrated Automated Thrombogram to Assess Direct Oral Anticoagulants [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-fibwave-a-new-sensitive-and-relevant-tool-for-analysing-the-fibrin-clot-formation-comparison-with-the-calibrated-automated-thrombogram-to-assess-direct-oral-anticoagulants/. Accessed October 1, 2023.
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