Impact of Dabigatran Treatment on Rotation Thromboelastometry
A rapid and reliable assessment of the dabigatran effect is desirable in dabigatran treated patients with uncontrolled bleeding or before acute surgery. The aim of this study was to study the anticoagulant effects of dabigatran in patients with atrial fibrillation (AF) as assessed by the whole blood...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-01-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/1076029620983902 |
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| author | Juraj Sokol MD, PhD Frantisek Nehaj MD Jela Ivankova RNDr Michal Mokan MD, PhD Jana Zolkova RNDr Lenka Lisa MD, PhD Ludmila Linekova MD Marian Mokan MD, DSc, FRCP Edin Jan Stasko MD, PhD |
| author_facet | Juraj Sokol MD, PhD Frantisek Nehaj MD Jela Ivankova RNDr Michal Mokan MD, PhD Jana Zolkova RNDr Lenka Lisa MD, PhD Ludmila Linekova MD Marian Mokan MD, DSc, FRCP Edin Jan Stasko MD, PhD |
| author_sort | Juraj Sokol MD, PhD |
| collection | DOAJ |
| description | A rapid and reliable assessment of the dabigatran effect is desirable in dabigatran treated patients with uncontrolled bleeding or before acute surgery. The aim of this study was to study the anticoagulant effects of dabigatran in patients with atrial fibrillation (AF) as assessed by the whole blood assays ROTEM, and how data from these methods correlate to plasma dabigatran concentrations measured by Hemoclot. ROTEM was performed with ROTEM Gamma (Pentapharm GmbH, Munich, Germany). The assays used in our study were Ex-tem and In-tem assay. Plasma dabigatran concentrations were determined by hemoclot thrombin inhibitor assay (Hyphen BioMed, France) at trough and post-dose in 27 patients on dabigatran 150 mg BID. Median plasma dabigatran concentrations at trough were 74 ng/mL (11.2–250) and post-dose (2 h after ingestion) 120 ng/mL (31–282). The ROTEM clotting time (CT) and maximum clot firmnes (MCF) correlated strongly with dabigatran concentrations when activated with the reagents Ex-tem (p < 0.0001) and In-tem (p < 0.0001). In summary, in our study, we have found that the ROTEM variable CT and MCF, when activated with triggers Ex-tem and In-tem, has a strong and highly significant correlation with the plasma dabigatran concentration in a real-life population of AF-patients and could thereby be an alternative to estimate dabigatran concentration in emergency situations. However, additional studies are needed to further validate these findings. |
| first_indexed | 2024-12-13T13:45:44Z |
| format | Article |
| id | doaj.art-45ffc6ca78f2438e8496473c24f36106 |
| institution | Directory Open Access Journal |
| issn | 1938-2723 |
| language | English |
| last_indexed | 2024-12-13T13:45:44Z |
| publishDate | 2021-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj.art-45ffc6ca78f2438e8496473c24f361062022-12-21T23:43:27ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232021-01-012710.1177/1076029620983902Impact of Dabigatran Treatment on Rotation ThromboelastometryJuraj Sokol MD, PhD0Frantisek Nehaj MD1Jela Ivankova RNDr2Michal Mokan MD, PhD3Jana Zolkova RNDr4Lenka Lisa MD, PhD5Ludmila Linekova MD6Marian Mokan MD, DSc, FRCP Edin7Jan Stasko MD, PhD8 Department of Haematology and Transfusion Medicine, National Centre of Haemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia First Department of Internal Medicine, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia Department of Haematology and Transfusion Medicine, National Centre of Haemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia First Department of Internal Medicine, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia Department of Haematology and Transfusion Medicine, National Centre of Haemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia Department of Haematology and Transfusion Medicine, National Centre of Haemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia Department of Haematology and Transfusion Medicine, National Centre of Haemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia First Department of Internal Medicine, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia Department of Haematology and Transfusion Medicine, National Centre of Haemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, SlovakiaA rapid and reliable assessment of the dabigatran effect is desirable in dabigatran treated patients with uncontrolled bleeding or before acute surgery. The aim of this study was to study the anticoagulant effects of dabigatran in patients with atrial fibrillation (AF) as assessed by the whole blood assays ROTEM, and how data from these methods correlate to plasma dabigatran concentrations measured by Hemoclot. ROTEM was performed with ROTEM Gamma (Pentapharm GmbH, Munich, Germany). The assays used in our study were Ex-tem and In-tem assay. Plasma dabigatran concentrations were determined by hemoclot thrombin inhibitor assay (Hyphen BioMed, France) at trough and post-dose in 27 patients on dabigatran 150 mg BID. Median plasma dabigatran concentrations at trough were 74 ng/mL (11.2–250) and post-dose (2 h after ingestion) 120 ng/mL (31–282). The ROTEM clotting time (CT) and maximum clot firmnes (MCF) correlated strongly with dabigatran concentrations when activated with the reagents Ex-tem (p < 0.0001) and In-tem (p < 0.0001). In summary, in our study, we have found that the ROTEM variable CT and MCF, when activated with triggers Ex-tem and In-tem, has a strong and highly significant correlation with the plasma dabigatran concentration in a real-life population of AF-patients and could thereby be an alternative to estimate dabigatran concentration in emergency situations. However, additional studies are needed to further validate these findings.https://doi.org/10.1177/1076029620983902 |
| spellingShingle | Juraj Sokol MD, PhD Frantisek Nehaj MD Jela Ivankova RNDr Michal Mokan MD, PhD Jana Zolkova RNDr Lenka Lisa MD, PhD Ludmila Linekova MD Marian Mokan MD, DSc, FRCP Edin Jan Stasko MD, PhD Impact of Dabigatran Treatment on Rotation Thromboelastometry Clinical and Applied Thrombosis/Hemostasis |
| title | Impact of Dabigatran Treatment on Rotation Thromboelastometry |
| title_full | Impact of Dabigatran Treatment on Rotation Thromboelastometry |
| title_fullStr | Impact of Dabigatran Treatment on Rotation Thromboelastometry |
| title_full_unstemmed | Impact of Dabigatran Treatment on Rotation Thromboelastometry |
| title_short | Impact of Dabigatran Treatment on Rotation Thromboelastometry |
| title_sort | impact of dabigatran treatment on rotation thromboelastometry |
| url | https://doi.org/10.1177/1076029620983902 |
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