Maki Komiyama1, Yusuke Miyazaki2, Hiromichi Wada3, Moritake Iguchi4, Mitsuru Abe4, Hisashi Ogawa4, Masaharu Akao4, Hajime Yamakage3, Noriko Satoh-Asahara3, Yoichi Sunagawa5, Tatsuya Morimoto5, Koji Hasegawa3. 1. Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. Electronic address: nikonikomakirin@yahoo.co.jp. 2. Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan; Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka, Japan. 3. Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. 4. Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. 5. Division of Molecular Medicine, School of Pharmaceutical Sciences, University of Shizuoka, Japan.
Abstract
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.
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 fibrillationpatients 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.
Authors: Philippe Maury; Slimane Belaid; Agnès Ribes; Quentin Voglimacci-Stephanopoli; Pierre Mondoly; Marie Blaye; Franck Mandel; Benjamin Monteil; Didier Carrié; Michel Galinier; Vanina Bongard; Anne Rollin; Sophie Voisin Journal: J Arrhythm Date: 2020-05-19