Monitoring anti-factor Xa activity in patients with chronic thromboembolic pulmonary hypertension treated with factor Xa inhibitors

Direct oral anticoagulants (DOACs) have been used clinically in patients with chronic thromboembolic pulmonary hypertension (CTEPH) for secondary prevention after acute venous thromboembolism, although the data are limited. We evaluated the effects of DOACs—especially factor Xa (FXa) inhibitors—by m...

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Bibliographic Details
Published in:Scientific reports 2024-10, Vol.14 (1), p.25762-10, Article 25762
Main Authors: Nakano, Yoshihisa, Adachi, Shiro, Hirose, Miku, Adachi, Takeshi, Nishiyama, Itsumure, Yasuda, Kenichiro, Yoshida, Masahiro, Kondo, Takahisa, Murohara, Toyoaki
Format: Article
Language:English
Subjects:
692/4019/592/75
692/699/75/593/1839
Aged
Aged, 80 and over
Anticoagulants
Chronic Disease
Chronic thromboembolic pulmonary hypertension
Direct-acting oral anticoagulant
pulmonary thromboembolism
Dosage
Drug Monitoring
Factor Xa
Factor Xa - metabolism
Factor Xa Inhibitors - therapeutic use
Female
Heparin
Humanities and Social Sciences
Humans
Hypertension
Hypertension, Pulmonary - drug therapy
Hypertension, Pulmonary - etiology
Inhibitors
Male
Middle Aged
multidisciplinary
Pulmonary Embolism - blood
Pulmonary Embolism - drug therapy
Pulmonary hypertension
Pyrazoles - therapeutic use
Pyridines - therapeutic use
Pyridones - administration & dosage
Pyridones - therapeutic use
Rivaroxaban - administration & dosage
Rivaroxaban - therapeutic use
Science
Science (multidisciplinary)
Thiazoles - administration & dosage
Thiazoles - pharmacology
Thiazoles - therapeutic use
Thromboembolism
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Summary:Direct oral anticoagulants (DOACs) have been used clinically in patients with chronic thromboembolic pulmonary hypertension (CTEPH) for secondary prevention after acute venous thromboembolism, although the data are limited. We evaluated the effects of DOACs—especially factor Xa (FXa) inhibitors—by measuring anti-factor Xa activity (AXA). Fifty consecutive CTEPH patients treated with rivaroxaban, apixaban, or edoxaban were enrolled. Heparin-calibrated AXA was measured at peak and trough. The median peak heparin-calibrated AXA across all 50 patients was 1.90 IU/mL and was comparable among the three FXa inhibitors. At trough, heparin-calibrated AXA was significantly higher in apixaban-treated patients (median 0.70 IU/mL) than in those given rivaroxaban (median 0.11 IU/mL) or edoxaban (median 0.11 IU/mL, p  
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-024-74481-7