Automated Thrombin Generation Assay for Rivaroxaban, Apixaban, and Edoxaban Measurements.

Details

Serval ID
serval:BIB_7AFB2F895DFC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Automated Thrombin Generation Assay for Rivaroxaban, Apixaban, and Edoxaban Measurements.
Journal
Frontiers in cardiovascular medicine
Author(s)
Meihandoest T., Studt J.D., Mendez A., Alberio L., Fontana P., Wuillemin W.A., Schmidt A., Graf L., Gerber B., Maeder G.M., Bovet C., Sauter T.C., Nagler M.
ISSN
2297-055X (Print)
ISSN-L
2297-055X
Publication state
Published
Issued date
2021
Peer-reviewed
Oui
Volume
8
Pages
717939
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Background: The thrombin generation assay (TG) is a promising approach to measure the degree of anticoagulation in patients treated with direct oral anticoagulants (DOAC). A strong association with plasma drug concentrations would be a meaningful argument for the potential use to monitor DOAC. Objectives: We aimed to study the correlation of TG with rivaroxaban, apixaban, and edoxaban drug concentrations in a large, prospective multicenter cross-sectional study. Methods: Five-hundred and fifty-nine patients were included in nine tertiary hospitals. The Technothrombin® TG was conducted in addition to an anti-Xa assay; LC-MS/MS was performed as the reference standard. Results: Correlation (r <sub>s</sub> ) between thrombin generation measurements and drug concentrations was -0.72 for peak thrombin generation (95% confidence interval, CI, -0.77, -0.66), -0.55 for area under the curve (AUC; 95% CI -0.61, -0.48), and 0.80 for lag time (95% CI 0.75, 0.84). In contrast, r <sub>s</sub> was 0.96 with results of the anti-Xa activity (95% CI 0.95-0.97). Sensitivity with regard to the clinically relevant cut-off value of 50 μgL <sup>-1</sup> was 49% in case of peak thrombin generation (95% CI, 44, 55), 29% in case of AUC (95% CI, 24, 34), and 64% in case of lag time (95% CI, 58, 69). Sensitivity of the anti-Xa assay was 95% (95% CI, 92, 97). Conclusions: The correlation of thrombin generation measurements with DOAC drug concentrations was weak, and clinically relevant drug levels were not predicted correctly. Our results do not support an application of TG in the monitoring of DOAC.
Keywords
anti-Xa assay, apixaban, diagnostic accuracy, direct oral anticoagulants, edoxaban, laboratory monitoring, rivaroxaban, thrombin generation assay
Pubmed
Web of science
Open Access
Yes
Create date
01/10/2021 16:54
Last modification date
21/10/2021 5:40
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