Key result
Excessively prolonged APTT after dabigatran linked to ~15 mg/dL lower HDL-C levels.
Why the study?
Factors contributing to excessive activated partial thromboplastin time prolongation after dabigatran administration remained to be analyzed.
What factors are associated with excessive APTT prolongation in patients with nonvalvular atrial fibrillation receiving dabigatran?
Observational (n=130)
No
What factors are associated with excessive APTT prolongation in patients with nonvalvular atrial fibrillation receiving dabigatran?
Absolute Event Rate: 40.7% vs 55.2%
p-value: p=0.0055
Lower HDL-C levels were associated with excessive APTT prolongation after dabigatran administration, highlighting a potential novel factor influencing dabigatran pharmacodynamics.
Clinicians should not modify dabigatran regimens based on cardiac index; leaves open its association pending higher-level evidence.
In this study, we compared patients whose activated partial thromboplastin time (APTT) was prolonged excessively with those whose APTT was controlled within the normal range after dabigatran administration. We analyzed the factors for the APTT prolongation. We divided the patients into two groups: those whose APTTs prolonged to more than 65 s and those whose APTTs were less than 65 s after dabigatran administration. There were 130 patients from March 2011 to July 2013, and we analyzed the background features and laboratory data of these patients. Results showed that there were no significant differences in the patients' background and laboratory data except for the high-density lipoprotein cholesterol (HDL-C) level. However, details of the relationship between the APTT prolongation and the HDL-C level are currently unknown. We hypothesize that the reason for the APTT prolongation is the variability in such parameters as the time of blood drawing, internal time of dabigatran, individual variability, and blood concentration. Therefore, we consider that these parameters need to be carefully evaluated even if APTT does not show prolongation.
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Kose et al. (2015) conducted an observational in Nonvalvular atrial fibrillation (n=130). Dabigatran vs. Controlled APTT (<65 s) was evaluated on HDL-C level (mg/dL) (p=0.0055). Patients with excessively prolonged APTT (≥65 s) after dabigatran administration had significantly lower HDL-C levels (40.7 mg/dL) compared to those with controlled APTT (55.2 mg/dL).
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