What is the clinical evidence from this study?

Study design: Observational. Population: Deep vein thrombosis or atrial fibrillation (n=100). Intervention: Coagulation tests (PT, aPTT, dRVVT) vs. Anti-FXa assay (reference standard). Primary outcome: Sensitivity and specificity of PT, aPTT, and dRVVT for detecting clinically relevant rivaroxaban plasma concentrations.

July 21, 2017Thrombosis JournalOpen Access

Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy study

View Full Paper

Ask AI

Bookmark

Key result

Dilute Russell viper venom time (dRVVT) demonstrated 100% sensitivity for detecting clinically relevant rivaroxaban plasma concentrations, while prothrombin time (PT) and activated partial thromboplastin time (aPTT) showed higher specificity.

Why the study?

Do PT, aPTT, and dRVVT accurately evaluate the hemorrhagic risk by estimating plasma concentration in patients taking rivaroxaban compared to anti-FXa assay?

Population

Convenience sample of 40 clinically stable patients using rivaroxaban to treat deep vein thrombosis or…

Comparison

Laboratory tests including prothrombin time… vs Plasmatic concentration measured by anti-FXa…

Design

Cross-sectional

Authors

MCMarjorie Paris ColombiniHospital Israelita Albert Einstein PDPriscilla Bento Matos Cruz DerogisHospital Israelita Albert Einstein VAValdir Fernandes de ArandaHospital Israelita Albert Einstein

Discussion

Member takes

Implication

dRVVT may aid sensitive rivaroxaban detection in select settings; leaves open prospective outcome validation versus PT/aPTT.

Study Design

Type

Observational (n=100)

Multicenter

Structured PICO

Do PT, aPTT, and dRVVT accurately evaluate the hemorrhagic risk by estimating plasma concentration in patients taking rivaroxaban compared to anti-FXa assay?

Population

40 clinically stable patients using rivaroxaban for deep vein thrombosis or atrial fibrillation and 60 healthy controls evaluated for diagnostic accuracy of coagulation tests.

Exposure

Laboratory tests including prothrombin time (PT), activated partial thromboplastin time (aPTT), and Dilute Russell viper venom time (dRVVT screen and confirm).

Comparator

Plasmatic concentration measured by anti-FXa assay (reference standard).

Outcome

Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PT, aPTT, and dRVVT to exclude qualitatively the plasma concentrations relevant in critical care (thresholds <30, <50, and <100 ng/mL).surrogate

dRVVT is a highly sensitive screening test for detecting clinically relevant rivaroxaban plasma concentrations, but requires a second test like anti-FXa or PT to improve specificity.

Limitations

Reduced and highly homogeneous and clinically stable sample of patients
Positive and negative predictive values are highly dependent on disease prevalence
Reduced and highly homogeneous and clinically stable sample of patients, which might not be the case of other emergency settings.

Cite This Study

Colombini et al. (2017) conducted an observational in Deep vein thrombosis or atrial fibrillation (n=100). Coagulation tests (PT, aPTT, dRVVT) vs. Anti-FXa assay (reference standard) was evaluated on Sensitivity and specificity of PT, aPTT, and dRVVT for detecting clinically relevant rivaroxaban plasma concentrations. Dilute Russell viper venom time (dRVVT) demonstrated 100% sensitivity for detecting clinically relevant rivaroxaban plasma concentrations, while prothrombin time (PT) and activated partial thromboplastin time (aPTT) showed higher specificity.

synapsesocial.com/papers/6a7324e00c0db29dfc2c1886 https://doi.org/10.1186/s12959-017-0140-6

View Full Paper

Ask AI

Bookmark

Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy study

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy study

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider