Key result
A simulation of atrial fibrillation patients derived a target trough plasma dabigatran concentration of 30-130 μg/L, proposing the thrombin time assay to guide dose-adjustment.
Why the study?
Can thrombin time be used to guide dose-adjustment of dabigatran to achieve target trough plasma concentrations in patients with atrial fibrillation?
Can thrombin time be used to guide dose-adjustment of dabigatran to achieve target trough plasma concentrations in patients with atrial fibrillation?
Proposes a target trough dabigatran concentration range of 30-130 μg/L and suggests thrombin time can be used for routine monitoring to optimize safety and efficacy in AF patients.
Thrombin time should not guide dabigatran dosing yet; leaves open validation of the 30-130 μg/L target in atrial fibrillation.
Dabigatran is an oral anticoagulant that is increasingly used for atrial fibrillation (AF). Presently, many authorities state that routine laboratory coagulation monitoring is not required. However, data have recently been published demonstrating that higher trough plasma dabigatran concentrations are associated with lower thromboembolic and higher haemorrhagic event rates. Using these data, we simulate a range of AF patients with varying risks for these events and derive a target range of trough plasma dabigatran concentrations (30-130 μg l(-1) ). Finally, we propose that a conventional screening coagulation assay, the thrombin time (TT), can be used to discern whether or not patients are within this range of dabigatran concentrations.
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Chin et al. (2014) studied Atrial fibrillation. Dabigatran etexilate was evaluated. A simulation of atrial fibrillation patients derived a target trough plasma dabigatran concentration of 30-130 μg/L, proposing the thrombin time assay to guide dose-adjustment.
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