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https://www.readbyqxmd.com/read/28888219/factor-xa-inhibition-by-rivaroxaban-in-the-trough-steady-state-can-significantly-reduce-thrombin-generation
#1
Shigeo Horinaka, Rie Sugawara, Yutaka Yonezawa, Toshihiko Ishimitsu
AIMS: The aim of the present study was to demonstrate evidence of reduced thrombin generation at the trough plasma rivaroxaban concentration. METHODS: A single-centre, prospective, non-randomised, drug intervention, self-controlled study was conducted in 51 anticoagulation therapy-naïve patients with non-valvular atrial fibrillation. Plasma rivaroxaban concentration was measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) and anti-factor Xa chromogenic assay...
September 9, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28884611/an-evaluation-of-the-activated-partial-thromboplastin-time-waveform
#2
Takeshi Matsumoto, Hideo Wada, Naoki Fujimoto, Junki Toyoda, Yasunori Abe, Kohshi Ohishi, Yoshiki Yamashita, Makoto Ikejiri, Kei Hasegawa, Kei Suzuki, Hiroshi Imai, Kaname Nakatani, Naoyuki Katayama
The activated partial thromboplastin time (APTT) waveform includes several parameters that are related to various underlying diseases. The APTT waveform was examined in various diseases. Regarding the pattern of APTT waveform, a biphasic pattern of the first or second derivative curve (DC) was observed in patients with hemophilia and patients positive for antiphospholipid (aPL) antibodies or coagulation factor VIII (FVIII) inhibitors. The time of the first and second DC and fibrin formation at 1/2 height were prolonged in patients with hemophilia, patients with inhibitors, patients positive for aPL, patients treated with anti-Xa agents, and patients with disseminated intravascular coagulation (DIC)...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28875044/decreased-rivaroxaban-levels-in-a-patient-with-cerebral-vein-thrombosis-receiving-phenytoin
#3
Ana F Becerra, Tomas Amuchastegui, Aldo H Tabares
Combined use of antiepileptic drugs and anticoagulants is common. We describe the first case documenting laboratory interaction between rivaroxaban and phenytoin. A 48-year-old woman was admitted to our hospital due to cerebral venous thrombosis, bilateral pulmonary embolism, and deep vein thrombosis. She came from a small town with difficult access to warfarin monitoring. She was receiving phenytoin 100 mg three times daily (t.i.d.) and started enoxaparin 60 mg twice daily (b.i.d.). An abdominal mass was diagnosed and removed by laparoscopy (gastrointestinal stromal tumor)...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28869359/monitoring-of-hemostatic-abnormalities-in-major-orthopedic-surgery-patients-treated-with-edoxaban-by-aptt-waveform
#4
M Hasegawa, H Wada, S Tone, T Yamaguchi, H Wakabayashi, M Ikejiri, M Watanabe, N Fujimoto, T Matsumoto, K Ohishi, Y Yamashita, N Katayama, A Sudo
INTRODUCTION: An analysis of the activated partial thromboplastin time (APTT) in major orthopedic surgery patients receiving edoxaban for the prevention of venous thromboembolism (VTE) was carried out. METHODS: The APTT waveform was analyzed in the above patients to monitor edoxaban administration. RESULTS: Of these 99 patients, 12 exhibited deep vein thrombosis, and 25 had massive bleeding. An increased biphasic pattern of the APTT waveform was observed after the administration of edoxaban, but there were no significant differences between the patients with and without complications...
September 4, 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28842030/development-of-a-nanostructured-immunosensor-for-early-and-in-situ-detection-of-xanthomonas-arboricola-in-agricultural-food-production
#5
Matías Regiart, Martin Rinaldi-Tosi, Pedro R Aranda, Franco A Bertolino, Jhonny Villarroel-Rocha, Karim Sapag, Germán A Messina, Julio Raba, Martín A Fernández-Baldo
We report a microfluidic electrochemical immunosensor for Xanthomonas arboricola (XA) determination, based on the covalently immobilization of monoclonal anti-XA antibody (anti-XA) on a previously amino functionalized SBA-15 in situ synthesized in the central channel of a glass-poly(dimethylsiloxane) microfluidic immunosensor. The synthetized amino-SBA-15 was characterized by N2 adsorption-desorption isotherm, scanning electron microscopy and infrared spectroscopy. XA was detected by a direct sandwich immunoassay through an alkaline phosphatase (AP) enzyme-labeled anti-XA conjugate...
December 1, 2017: Talanta
https://www.readbyqxmd.com/read/28840739/-rivaroxaban-in-high-risk-patients
#6
Jindřich Špinar, Lenka Špinarová
Blockade of factor Xa becomes a routine part of clinical practice instead of vitamin K blockade with warfarin, providing a more beneficial and safer effect. The main indications are prevention of stroke and systemic embolism in adults with nonvalvular atrial fibrillation, deep vein thrombosis and pulmonary embolism. Rivaroxaban has the largest number of data across high risk patients. Rivaroxaban is an oral selective anti Xa inhibitor with well predictive pharmacokinetics and pharmacodynamics. It inhibits thrombin formation for 24 hours, is well absorbed and biological availability is 80-100 %...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28821169/predictors-of-pre-procedural-concentrations-of-direct-oral-anticoagulants-a-prospective-multicentre-study
#7
Anne Godier, Anne-Sophie Dincq, Anne-Céline Martin, Adrian Radu, Isabelle Leblanc, Marion Antona, Marc Vasse, Jean-Louis Golmard, François Mullier, Isabelle Gouin-Thibault
Aims: Patients receiving direct oral anticoagulants (DOACs) frequently undergo elective invasive procedures. Their management is challenging. We aimed to determine the optimal duration of DOAC discontinuation that ensures a minimal anticoagulant effect during the procedure. Methods and results: This prospective multicentre study included 422 DOAC-treated patients requiring an invasive procedure. Pre-procedural DOAC concentration ([DOAC]) and routine haemostasis assays were performed to determine i/the proportion of patients who achieved a minimal pre-procedural [DOAC] (≤30 ng/mL) according to the duration of DOAC discontinuation, ii/the predictors of minimal [DOAC] and, iii/the ability of routine assays to predict minimal [DOAC]...
August 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28820035/changes-in-heparin-dose-response-slope-during-cardiac-surgery-possible-result-in-inaccuracy-in-predicting-heparin-bolus-dose-requirement-to-achieve-target-act
#8
Junko Ichikawa, Tetsu Mori, Mitsuharu Kodaka, Keiko Nishiyama, Makoto Ozaki, Makiko Komori
INTRODUCTION: The substantial interpatient variability in heparin requirement has led to the use of a heparin dose response (HDR) technique. The accuracy of Hepcon-based heparin administration in achieving a target activated clotting time (ACT) using an HDR slope remains controversial. METHODS: We prospectively studied 86 adult patients scheduled for cardiac surgery requiring cardiopulmonary bypass. The total dose of calculated heparin required for patient and pump priming was administered simultaneously to achieve a target ACT of 450 s for HDR on the Hepcon HMS system...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28817831/practical-value-of-anti-xa-activity-in-the-evaluation-of-extracorporeal-circuit-anticoagulation-during-haemodialysis-results-of-a-cross-sectional-single-centre-study
#9
Karlien L M Coene, Marijke J E Dekker, Marieke C H M Kerskes, Maaike Hengst, Marc J M Schonck, Constantijn J A M Konings, Volkher Scharnhorst
BACKGROUND/AIMS: Anticoagulation of the extracorporeal circuit is essential for adequate haemodialysis (HD). Low molecular weight heparins (LMWHs) are safe and sufficient towards achieving this goal. In the Netherlands, dosage is based on bodyweight and adjusted based on clinical events. LMWH levels during dialysis can be quantified through measurement of the anti-Xa activity and a target range of 0.5-1.0 IU/mL has been proposed. We aimed to evaluate the practical value of the anti-Xa activity to guide LMWH dosage in HD patients...
August 18, 2017: Nephron
https://www.readbyqxmd.com/read/28808989/can-we-reliably-predict-the-level-of-anticoagulation-after-enoxaparin-injection-in-elderly-patients-with-renal-failure
#10
Luca Pellizzari, Roberto Facchinetti, Luigi Corrà, Anna Sepe, Francesco Fantin, Giorgia Fontana, Mauro Zamboni, Vincenzo Di Francesco
OBJECTIVES: The aim of this study was to evaluate the activity of anti-activated factor X (anti-Xa) in patients with different degrees of chronic renal failure (CRF), treated with therapeutic doses of low molecular weight heparin. DESIGN: This prospective study evaluated the effect of age, renal function, BMI, gender, in determining the efficacy and safety of treatment with enoxaparin, evaluated by assessing the anti-Xa. The therapeutic anticoagulant range was set between 0...
August 14, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28808492/assessment-of-anti-factor-xa-activity-of-enoxaparin-for-venous-thromboembolism-prophylaxis-in-morbidly-obese-surgical-patients
#11
Nouf Al Otaib, Zohour Bootah, Maha A Al Ammari, Tariq M Aldebasi, Abdulmalik M Alkatheri, Shmeylan A Al Harbi, Salah M AbuRuz, Abdulkareem M AlBekairy
BACKGROUND: Venous thromboembolism (VTE) can be encountered by 60% of hospitalized patients. Anticoagulants have been recommended to reduce the risk of VTE in patients with risk factors. However, no specific dosing recommendations for obese patients are provided in the current practice guidelines. The purpose of this study was to determine the efficacy and safety of weight-based dosing of enoxaparin for VTE prophylaxis among morbidly obese patients undergoing surgery. METHODS: Adult patients were enrolled if they have a body mass index (BMI) of ≥35 kg/m(2) and were scheduled for surgery...
July 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28804832/measuring-direct-oral-anticoagulants
#12
Robert C Gosselin, Jonathan Douxfils
Direct oral anticoagulants (DOACs) can be quantified using methods that can be performed in any clinical or research laboratory using manual or automated instrument platforms. Dabigatran etexilate, the oral direct thrombin inhibitor, can be quantified by drug-calibrated clot or chromogenic-based assays using either thrombin or ecarin as substrates. Oral direct anti-Xa inhibitors, such as rivaroxaban, apixaban, and edoxaban, can be quantified with drug-calibrated anti-Xa kits or reagents as typically used for measuring heparins (unfractionated, low molecular weight, or pentasaccharides)...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28797813/sulfated-modification-and-anticoagulant-activity-of-pumpkin-cucurbita-pepo-lady-godiva-polysaccharide
#13
Li Liang, Le Ao, Tao Ma, Yuanying Ni, Xiaojun Liao, Xiaosong Hu, Yi Song
Sulfated modification of pumpkin polysaccharide using CAS with pyridines as catalysts under different conditions was conducted to obtain different degrees of sulfation on a laboratory scale. Anticoagulant activities of pumpkin polysaccharide and its sulfated derivatives were also investigated employing various established in vitro systems. Results showed that addition of high ratio of CAS/pyridine under constant conditions could increase the degree of substitution. Sulfate substitution was further confirmed by the FT-IR and 13C NMR analysis...
August 7, 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/28775134/emergency-coagulation-assessment-during-treatment-with-direct-oral-anticoagulants-limitations-and-solutions
#14
Matthias Ebner, Ingvild Birschmann, Andreas Peter, Florian Härtig, Charlotte Spencer, Joachim Kuhn, Gunnar Blumenstock, Christine S Zuern, Ulf Ziemann, Sven Poli
BACKGROUND AND PURPOSE: In patients receiving direct oral anticoagulants (DOACs), emergency treatment like thrombolysis for acute ischemic stroke is complicated by insufficient availability of DOAC-specific coagulation tests. Conflicting recommendations have been published concerning the use of global coagulation assays for ruling out relevant DOAC-induced anticoagulation. METHODS: Four hundred eighty-one samples from 96 DOAC-treated patients were tested using prothrombin time (PT), activated partial thromboplastin time (aPTT) and thrombin time (TT), DOAC-specific assays (anti-Xa activity, diluted TT), and liquid chromatography-tandem mass spectrometry...
September 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28767200/correlation-between-activated-partial-thromboplastin-time-and-anti-xa-activity-in-patients-who-received-low-molecular-weight-heparin-as-anticoagulation-for-haemodialysis
#15
Steve Siu-Man Wong, Wai-Yan Lau, Ping-Kwan Chan, Ching-Kit Wan, Yuk-Lun Cheng
Plasma anti-Xa activity, the recommended test to monitor low-molecular weight heparin (LMWH) therapy, is not readily available in many laboratories. In our clinical trials on the use of LMWH as anticoagulation for haemodialysis, a consistent prolongation of APTT in addition to the elevated anti-Xa activity was observed in the patients after LMWH administration. Hence, the paired anti-Xa activity and APTT data were re-analyzed. The APTT ratio, which was the proportional change in APTT from the baseline value after LMWH administration, was found to have a strong correlation with anti-Xa activity (coefficient of determination, R(2) = 0...
August 2, 2017: Nephrology
https://www.readbyqxmd.com/read/28759760/should-we-abandon-the-aptt-for-monitoring-unfractionated-heparin
#16
D R J Arachchillage, F Kamani, S Deplano, W Banya, M Laffan
INTRODUCTION: The activated partial thromboplastin time (APTT) is commonly used to monitor unfractionated heparin (UFH) but may not accurately measure the amount of heparin present. The anti-Xa assay is less susceptible to confounding factors and may be a better assay for this purpose. MATERIALS AND METHODS: The validity of the APTT for monitoring UFH was assessed by comparing with an anti-Xa assay on 3543 samples from 475 patients (infants [n=165], children 1-15years [n=60] and adults [n=250]) receiving treatment dose UFH...
July 6, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28735423/the-anticoagulant-effect-of-heparin-during-radiofrequency-ablation-rfa-in-patients-taking-apixaban-or-rivaroxaban
#17
L C Brendel, F Dobler, G Hessling, J Michel, S L Braun, A L Steinsiek, P Groha, R Eckl, I Deisenhofer, A Hyseni, M Roest, I Ott, B Steppich
PURPOSE: Measuring the anticoagulant effect of heparin during radiofrequency ablation (RFA) in patients taking apixaban and rivaroxaban is challenging, since the activated coagulation time (ACT) does not seem to reflect the true anticoagulant activity of these drugs. We therefore evaluated coagulation properties of apixaban and rivaroxaban during RFA by different coagulation assays to better monitor periprocedural hemostasis. METHODS: The study included 90 patients (61 ± 12 years) with atrial fibrillation who underwent RFA procedures...
September 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28708713/platelet-aggregation-in-direct-oral-factor-xa-inhibitors-treated-patients-with-atrial-fibrillation-a-pilot-study
#18
Peter Bánovčin, Ingrid Škorňová, Matej Samoš, Martin Schnierer, Tomáš Bolek, František Kovář, Ján Staško, Peter Kubisz, Marián Mokáň
BACKGROUND: Activated factor X (factor Xa) plays an important role in regulation of platelets. The aim of this study was to test the effect of direct oral factor Xa inhibitors - rivaroxaban and apixaban - on platelet aggregation in patients with non-valvular atrial fibrillation (NV-AF). PATIENTS AND METHODS: This single-centre pilot study enrolled 21 factor Xa inhibitors-treated (9 rivaroxaban-treated and 12 apixaban-treated) patients with NV-AF. The trough and peak samples of these patients were tested for adenosinediphosphate-induced (ADP), epinephrine-induced, and collagen-induced platelet aggregation with light transmission aggregometry (LTA), and with factor Xa-calibrated anti-Xa chromogenic analysis...
July 13, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28693359/coagulation-monitoring-correlation-with-heparin-dose-in-pediatric-extracorporeal-life-support
#19
Katie Moynihan, Kerry Johnson, Lahn Straney, Christian Stocker, Ben Anderson, Prem Venugopal, John Roy
OBJECTIVES: Extracorporeal Life Support (ECLS) risks thrombotic and hemorrhagic complications. Optimal anti-coagulation monitoring is controversial. We compared coagulation tests evaluating the heparin effect in pediatric ECLS. METHODS: A retrospective study of children (<18yrs) undergoing ECLS over 12 months in a tertiary pediatric intensive care unit (PICU). Variables included anti-Factor Xa activity (anti-Xa), activated partial thromboplastin time (aPTT), activated clotting time (ACT) and thromboelastogram (TEG(®)6s) parameters: ratio and delta reaction (R) times (the ratio and difference, respectively, between R times in kaolin assays with and without heparinase)...
July 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28673500/-state-of-the-art-direct-oral-anticoagulants-and-transfusion
#20
A-C Martin, A Godier, D M Smadja, L Mauge, A-M Fischer
Direct oral anticoagulants (DOAC) are indicated for stroke prevention in atrial fibrillation and for the prevention and treatment of venous thromboembolism. As any anticoagulant, they are associated with a bleeding risk. Management of DOAC-induced bleeding is challenging. Idarucizumab, antidote for dabigatran, is currently available and is part of the therapeutic strategy, whereas antidotes for anti-Xa agents are under development. Activated or non-activated prothrombin concentrates are proposed, although their efficacy to reverse DOAC is uncertain...
June 30, 2017: Transfusion Clinique et Biologique: Journal de la Société Française de Transfusion Sanguine
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