Back to Search
Start Over
Monitoring the roles of prothrombin activation fragment 1 and 2 (F1 + 2) in patients with atrial fibrillation receiving rivaroxaban and apixaban.
- Source :
-
Journal of thrombosis and thrombolysis [J Thromb Thrombolysis] 2020 Aug; Vol. 50 (2), pp. 371-379. - Publication Year :
- 2020
-
Abstract
- Factor Xa (FXa) inhibitors are recommended for use in fixed doses without laboratory monitoring. However, prior studies reported the importance of establishing biomarkers representing anticoagulation intensity related to bleeding or thrombotic events. To test the hypothesis that prothrombin activation fragment 1 and 2 (F1 + 2), a non-specific marker of thrombin generation, could be altered during FXa inhibitor treatment in patients with atrial fibrillation. We conducted the study in two different clinical settings. First, the interrelations among biomarkers representing coagulation/fibrinolysis were investigated in 80 patients in an outpatient clinic. Second, these biomarkers were evaluated in 75 patients who underwent radiofrequency catheter ablation. Plasma concentration of FXa inhibitors was evaluated using an anti-FXa chromogenic assay (C-Xa). In the outpatient study, only F1 + 2 exhibited a significant and negative association with C-Xa (rS = - 0.315, p = 0.026), and 37% of the variance could be explained by C-Xa levels. F1 + 2 levels above the reference range (> 229 pmol/L) could be considered as a cut-off to identify poor patient compliance or under-dosing. In the peri-ablation study, increased F1 + 2 levels were associated with decline of C-Xa levels after periprocedural discontinuation of FXa inhibitors, which was greater in the rivaroxaban group than in the apixaban group. F1 + 2 showed modest and inverse association with plasma concentration of rivaroxaban and apixaban in patients with atrial fibrillation. Larger study to test the hypothesis that continued thrombin generation despite anticoagulation is associated with a heightened risk of clinical events is required.
- Subjects :
- Aged
Aged, 80 and over
Atrial Fibrillation blood
Atrial Fibrillation diagnosis
Atrial Fibrillation surgery
Biomarkers blood
Catheter Ablation
Factor Xa Inhibitors adverse effects
Female
Humans
Male
Prothrombin
Pyrazoles adverse effects
Pyridones adverse effects
Rivaroxaban adverse effects
Time Factors
Treatment Outcome
Atrial Fibrillation drug therapy
Drug Monitoring
Factor Xa Inhibitors therapeutic use
Peptide Fragments blood
Pyrazoles therapeutic use
Pyridones therapeutic use
Rivaroxaban therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1573-742X
- Volume :
- 50
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of thrombosis and thrombolysis
- Publication Type :
- Academic Journal
- Accession number :
- 32166540
- Full Text :
- https://doi.org/10.1007/s11239-020-02079-7