Key result
Higher C-peak DOAC levels are linked to more frequent bleeding complications over one year.
Why the study?
DOACs are administered at fixed doses without laboratory monitoring, and the relationship between C-trough or C-peak plasma levels and bleeding complications in NVAF patients required evaluation.
Do higher DOAC C-peak plasma levels increase the risk of bleeding complications in patients with non-valvular atrial fibrillation?
Comparison
DOAC plasma levels across four equal classes of C-trough and C-peak
Design
Prospective cohort study
Follow-up
1 year
Authors
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May identify higher bleeding risk on DOACs in NVAF; leaves open whether C-peak monitoring improves outcomes in trials.
Cohort (n=565)
Do higher DOAC C-peak plasma levels increase the risk of bleeding complications in patients with non-valvular atrial fibrillation?
Higher C-peak DOAC levels are associated with increased bleeding complications in patients with non-valvular atrial fibrillation, suggesting a potential role for therapeutic monitoring.
Testa et al. (2019) conducted a cohort in non-valvular atrial fibrillation (NVAF) (n=565). Higher DOAC C-peak plasma levels vs. Lower DOAC C-peak plasma levels was evaluated on Bleeding complications (major, clinically relevant non-major, and minor bleeding). Higher C-peak direct oral anticoagulant plasma levels were associated with more frequent bleeding complications (overall 3.36% major, 1.06% clinically relevant non-major, 8.31% minor) over 1 year.
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