Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy study
Abstract Background Rivaroxaban is a direct oral anticoagulant designed to dispense with the necessity of laboratory monitoring. However, monitoring rivaroxaban levels is necessary in certain clinical conditions, especially in the critical care setting. Methods This is a diagnostic accuracy study ev...
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | Thrombosis Journal |
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| Online Access: | http://link.springer.com/article/10.1186/s12959-017-0140-6 |
| _version_ | 1818067758648131584 |
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| author | Marjorie Paris Colombini Priscilla Bento Matos Cruz Derogis Valdir Fernandes de Aranda João Carlos de Campos Guerra Nelson Hamerschlak Cristóvão Luis Pitangueiras Mangueira |
| author_facet | Marjorie Paris Colombini Priscilla Bento Matos Cruz Derogis Valdir Fernandes de Aranda João Carlos de Campos Guerra Nelson Hamerschlak Cristóvão Luis Pitangueiras Mangueira |
| author_sort | Marjorie Paris Colombini |
| collection | DOAJ |
| description | Abstract Background Rivaroxaban is a direct oral anticoagulant designed to dispense with the necessity of laboratory monitoring. However, monitoring rivaroxaban levels is necessary in certain clinical conditions, especially in the critical care setting. Methods This is a diagnostic accuracy study evaluating sensitivity and specificity of prothrombin time (PT), activated partial thromboplastin time (aPTT), and Dilute Russell viper venom time (dRVVT), to evaluate the hemorrhagic risk in patients taking rivaroxaban. The study used a convenience sample of 40 clinically stable patients using rivaroxaban to treat deep vein thrombosis or atrial fibrillation admitted in a private hospital in Brazil, compared to a group of 60 healthy controls. The samples from patients were collected two hours after the use of the medication (peak) and two hours before the next dose (trough). Results The correlation with the plasmatic concentration measured by anti-FXa assay was higher for PT and dRVVTS. The PT and aPTT tests presented higher specificity, while dRVVT was 100% sensible. Conclusions There was a strong correlation between the tests and the plasma concentration of the drug. Additionally, our results demonstrated the potential use of dRVVT as a screening test in the emergency room and the need of a second test to improve specificity. |
| first_indexed | 2024-12-10T15:28:46Z |
| format | Article |
| id | doaj.art-b79ce64ed7a947dea52c6176fdd196bb |
| institution | Directory Open Access Journal |
| issn | 1477-9560 |
| language | English |
| last_indexed | 2024-12-10T15:28:46Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Thrombosis Journal |
| spelling | doaj.art-b79ce64ed7a947dea52c6176fdd196bb2022-12-22T01:43:28ZengBMCThrombosis Journal1477-95602017-08-011511710.1186/s12959-017-0140-6Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy studyMarjorie Paris Colombini0Priscilla Bento Matos Cruz Derogis1Valdir Fernandes de Aranda2João Carlos de Campos Guerra3Nelson Hamerschlak4Cristóvão Luis Pitangueiras Mangueira5Department of Diagnostic and Preventive Medicine and Clinical Laboratory, Hospital Israelita Albert EinsteinDepartment of Diagnostic and Preventive Medicine and Clinical Laboratory, Hospital Israelita Albert EinsteinDepartment of Diagnostic and Preventive Medicine and Clinical Laboratory, Hospital Israelita Albert EinsteinDepartment of Diagnostic and Preventive Medicine and Clinical Laboratory, Hospital Israelita Albert EinsteinDepartment of Hematology, Hospital Israelita Albert EinsteinDepartment of Diagnostic and Preventive Medicine and Clinical Laboratory, Hospital Israelita Albert EinsteinAbstract Background Rivaroxaban is a direct oral anticoagulant designed to dispense with the necessity of laboratory monitoring. However, monitoring rivaroxaban levels is necessary in certain clinical conditions, especially in the critical care setting. Methods This is a diagnostic accuracy study evaluating sensitivity and specificity of prothrombin time (PT), activated partial thromboplastin time (aPTT), and Dilute Russell viper venom time (dRVVT), to evaluate the hemorrhagic risk in patients taking rivaroxaban. The study used a convenience sample of 40 clinically stable patients using rivaroxaban to treat deep vein thrombosis or atrial fibrillation admitted in a private hospital in Brazil, compared to a group of 60 healthy controls. The samples from patients were collected two hours after the use of the medication (peak) and two hours before the next dose (trough). Results The correlation with the plasmatic concentration measured by anti-FXa assay was higher for PT and dRVVTS. The PT and aPTT tests presented higher specificity, while dRVVT was 100% sensible. Conclusions There was a strong correlation between the tests and the plasma concentration of the drug. Additionally, our results demonstrated the potential use of dRVVT as a screening test in the emergency room and the need of a second test to improve specificity.http://link.springer.com/article/10.1186/s12959-017-0140-6AnticoagulantsDirect oral anticoagulantsRivaroxabanClinical laboratory techniquesProthrombin timeRussell’s viper venom time |
| spellingShingle | Marjorie Paris Colombini Priscilla Bento Matos Cruz Derogis Valdir Fernandes de Aranda João Carlos de Campos Guerra Nelson Hamerschlak Cristóvão Luis Pitangueiras Mangueira Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy study Thrombosis Journal Anticoagulants Direct oral anticoagulants Rivaroxaban Clinical laboratory techniques Prothrombin time Russell’s viper venom time |
| title | Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy study |
| title_full | Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy study |
| title_fullStr | Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy study |
| title_full_unstemmed | Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy study |
| title_short | Comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting: diagnostic accuracy study |
| title_sort | comparison of different laboratory tests in the evaluation of hemorrhagic risk of patients using rivaroxaban in the critical care setting diagnostic accuracy study |
| topic | Anticoagulants Direct oral anticoagulants Rivaroxaban Clinical laboratory techniques Prothrombin time Russell’s viper venom time |
| url | http://link.springer.com/article/10.1186/s12959-017-0140-6 |
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