Key result
Rivaroxaban and apixaban significantly suppressed fibrin-rich thrombus formation, with a strong correlation observed between antithrombotic capacity at trough and peak concentrations (r = 0.79, P = 0.001).
Why the study?
Can the Total Thrombus-Formation Analysis System (T-TAS) accurately monitor the anticoagulant effects of rivaroxaban and apixaban in whole blood?
Observational (n=36)
No
Can the Total Thrombus-Formation Analysis System (T-TAS) accurately monitor the anticoagulant effects of rivaroxaban and apixaban in whole blood?
Effect estimate: r = 0.79
p-value: p=0.001
The Total Thrombus-Formation Analysis System (T-TAS) may serve as a clinically useful and accurate quantitative tool for monitoring the anticoagulant effects of factor Xa inhibitors.
T-TAS detects rivaroxaban/apixaban effects in vitro/ex vivo; leaves open clinical monitoring utility pending prospective trials.
Background: The usefulness of the Total Thrombus-Formation Analysis System ® (T-TAS ® ) for monitoring the anticoagulant effects of non-vitamin K oral anticoagulants (NOACs) in clinical practice has been poorly addressed. Methods: NOACs (rivaroxaban and apixaban) were added to whole blood from healthy subjects in an in vitro study, and their effects on thrombus formation were evaluated by the T-TAS ® . We also evaluated antithrombotic effects using ex vivo samples of whole blood from patients given rivaroxaban or apixaban at the respective trough and peak drug concentrations. Results: T-TAS ® could determine anticoagulant effects in whole blood treated with rivaroxaban or apixaban in vitro . The increases in the anticoagulant effects of rivaroxaban and apixaban from the trough to peak concentrations in whole blood were successfully monitored by the T-TAS ® using ex vivo samples. The antithrombotic effects of rivaroxaban and apixaban (in terms of factor Xa inhibition) at the peak were strongly linked to those at the trough. Conclusion: T-TAS ® could be a clinically useful tool for monitoring the anticoagulant effects of factor Xa inhibitors, and may represent an accurate quantitative analysis. J Clin Med Res. 2016;8(12):899-907 doi: http://dx.doi.org/10.14740/jocmr2773w
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Sugihara et al. (2016) conducted an observational in Atrial Fibrillation (n=36). Rivaroxaban and Apixaban vs. Trough vs. peak concentrations (ex vivo) and control blood (in vitro) was evaluated on Thrombus formation measured by Area Under the Curve (AR-AUC) using the Total Thrombus-Formation Analysis System (r = 0.79, p=0.001). Rivaroxaban and apixaban significantly suppressed fibrin-rich thrombus formation, with a strong correlation observed between antithrombotic capacity at trough and peak concentrations (r = 0.79, P = 0.001).
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