Plasma clot formation and clot lysis to compare effects of different anticoagulation treatments on hemostasis in patients with atrial fibrillation

The effect of direct oral anticoagulants (DOACs) on turbidimetric measurements of plasma clot formation and susceptibility to fibrinolysis may facilitate a comparison between different classes of anticoagulants in plasma samples. We obtained 424 citrate plasma samples from 226 atrial fibrillation pa...

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Bibliographic Details
Published in:Clinical and experimental medicine 2018-08, Vol.18 (3), p.325-336
Main Authors: Königsbrügge, Oliver, Weigel, Günter, Quehenberger, Peter, Pabinger, Ingrid, Ay, Cihan
Format: Article
Language:English
Subjects:
Aged
Anticoagulants
Anticoagulants - pharmacology
Atrial Fibrillation - blood
Atrial Fibrillation - drug therapy
Atrial Fibrillation - physiopathology
Blood Coagulation - drug effects
Cardiac arrhythmia
Case-Control Studies
Catheters
Citric acid
Correlation analysis
Dabigatran - pharmacology
Factor Xa Inhibitors - pharmacology
Female
Fibrillation
Fibrin Clot Lysis Time
Fibrinolysis
Hematology
Hemostasis
Heparin
Heparin, Low-Molecular-Weight - pharmacology
Humans
Internal Medicine
Lag phase
Linear Models
Lysis
Male
Mass spectroscopy
Medicine
Medicine & Public Health
Middle Aged
Molecular weight
Oncology
Original Article
Patients
Phenprocoumon - pharmacology
Plasma - drug effects
Plasma - metabolism
Pyrazoles - pharmacology
Pyridones - pharmacology
Rivaroxaban - pharmacology
t-Plasminogen activator
Thrombomodulin
Thromboplastin - pharmacology
Tissue factor
Tissue Plasminogen Activator - pharmacology
Turbidity
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Summary:The effect of direct oral anticoagulants (DOACs) on turbidimetric measurements of plasma clot formation and susceptibility to fibrinolysis may facilitate a comparison between different classes of anticoagulants in plasma samples. We obtained 424 citrate plasma samples from 226 atrial fibrillation patients on anticoagulation and 24 samples without anticoagulation serving as controls. As comparators, we measured the international normalized ratio (INR) for phenprocoumon samples ( N  = 166), anti-Xa for low molecular weight heparin (LMWH) samples ( N  = 42), and DOAC levels with mass spectrometry (dabigatran N  = 40, rivaroxaban N  = 110, apixaban N  = 42). Plasma clot formation and lysis were recorded continuously on a photometer after addition of an activation mix (tissue factor 2 pmol/l and tissue plasminogen activator 333 ng/ml). We used linear regression and ANCOVA for correlation analysis. Clot formation lag phase was prolonged in the presence of anticoagulants in a concentration-dependent manner for DOACs (dabigatran Spearman r  = 0.74; rivaroxaban r  = 0.78; apixaban r  = 0.72, all p  
ISSN:1591-8890
1591-9528
DOI:10.1007/s10238-018-0490-9