Key result
Apixaban plasma concentration closely correlated with prothrombin time (β = 0.765, p < 0.001) and its percentage change from baseline (β = 0.650, p = 0.005) in patients with atrial fibrillation.
Why the study?
Does routinely measured prothrombin time (PT) correlate with apixaban plasma concentration in patients with nonvalvular atrial fibrillation?
Observational (n=18)
No
Does routinely measured prothrombin time (PT) correlate with apixaban plasma concentration in patients with nonvalvular atrial fibrillation?
Effect estimate: β = 0.765
p-value: p=< 0.001
Prothrombin time (PT) closely correlates with apixaban plasma concentration and may serve as a useful routine indicator for monitoring apixaban in patients with nonvalvular atrial fibrillation.
PT may track apixaban exposure in small prospective cohort; hypothesis-generating for routine monitoring, requires larger validation trials.
BACKGROUND: Depending on the characteristics of patients, the blood concentration of apixaban can unexpectedly increase, possibly leading to bleeding events. Anti-FXa activity reflects the apixaban blood concentration; however, measurement of this activity is both time-consuming and expensive. The current study aimed to evaluate the usefulness of routinely measured coagulation indices as future indicators of the efficacy and safety of apixaban. METHODS: Eighteen nonvalvular atrial fibrillation patients administered apixaban (average, 52.5 days) were prospectively enrolled in our hospital. The prothrombin time (PT) and the activated partial thromboplastin time (APTT) were measured by using the Coagpia® Reagent kits. RESULTS: The PT and the APTT increased significantly after the administration of apixaban (PT: p < 0.001, APTT: p < 0.001). While the apixaban plasma concentration by evaluating anti-FXa activity was not significantly correlated with the APTT after administration of apixaban, the concentration closely correlated with the PT (β = 0.765, p < 0.001) and the percentage change in the PT from before and after the administration of apixaban (β = 0.650, p = 0.005). CONCLUSION: The usefulness of routinely monitoring PT in patients administered apixaban during the ordinary clinical medicine should be investigated further by large clinical trials.
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Komiyama et al. (2018) conducted an observational in nonvalvular atrial fibrillation (n=18). Apixaban vs. Before administration of apixaban was evaluated on Correlation between apixaban plasma concentration (anti-FXa activity) and prothrombin time (PT) (β = 0.765, p=< 0.001). Apixaban plasma concentration closely correlated with prothrombin time (β = 0.765, p < 0.001) and its percentage change from baseline (β = 0.650, p = 0.005) in patients with atrial fibrillation.
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