A LMWH-calibrated anti-Xa activity <0.50 IU/mL could exclude a plasma concentration of rivaroxaban and apixaban >30 ng/mL, indicating the feasibility of invasive procedures.
Observational (n=210)
Can a LMWH-calibrated anti-Xa assay accurately evaluate the plasma concentration of oral anti-Xa inhibitors (rivaroxaban and apixaban) in emergency settings?
In emergency settings without specific tests, a LMWH-calibrated anti-Xa assay can be used to evaluate the plasma concentration of oral anti-Xa inhibitors to guide the feasibility of invasive procedures.
BACKGROUND: Oral anti-Xa inhibitors have demonstrated noninferiority to vitamin K antagonists (VKAs) for the prevention of stroke in patients with atrial fibrillation and recurrent venous thromboembolism. They are associated with a decrease in major bleeding. In contrast with VKA, no coagulation monitoring is required. However, in clinical practice, determination of drug concentration is sometimes necessary. OBJECTIVE: The objective of this study was to evaluate a low-molecular-weight heparin (LMWH) calibrated anti-Xa assay for the quantification of rivaroxaban and apixaban plasma concentration in emergency. METHODS: The anti-Xa plasma concentration of rivaroxaban and apixaban were measured in emergency in 210 patients using STA anti-Xa liquid assay. For each plasma concentration 30 ng/mL and indicate the feasibility of invasive procedure. Conclusion and Relevance: In the absence of a specific test, LMWH-calibrated anti-Xa assay could be used to determine the presence and evaluate the plasma concentration of oral anti-Xa inhibitors. However, these initial findings require confirmation using other chromogenic calibrated oral anti-Xa assays.
Billoir et al. (Wed,) conducted a observational in Emergency requiring quantification of rivaroxaban and apixaban (n=210). LMWH calibrated anti-Xa assay vs. STA anti-Xa liquid assay was evaluated on Plasma concentration of rivaroxaban and apixaban. A LMWH-calibrated anti-Xa activity <0.50 IU/mL could exclude a plasma concentration of rivaroxaban and apixaban >30 ng/mL, indicating the feasibility of invasive procedures.