Article
Hematology
Joseph R. Shaw, Na Li, Joanne Nixon, Karen A. Moffat, Alex C. Spyropoulos, Sam Schulman, James D. Douketis
Summary: Coagulation testing is not a reliable method for predicting DOAC concentrations. There is a weak correlation between coagulation assay results and DOAC levels, except for a moderate correlation between thrombin time and dabigatran concentrations. Prothrombin time and activated partial thromboplastin time have modest sensitivity but poor specificity in predicting DOAC levels.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Hematology
Myrthe M. A. Toorop, Nienke van Rein, Melchior C. Nierman, Helga W. Vermaas, Menno Huisman, Felix J. M. van der Meer, Suzanne C. Cannegieter, Willem M. Lijfering
Summary: The study found that the inter-individual variability of DOAC concentrations was higher than intra-individual variability, and lower previous VKA dosage and creatinine clearance were associated with higher DOAC trough concentrations.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2022)
Article
Pharmacology & Pharmacy
Allison Cid, Megan E. Smetana, Courtney Hebert, Kelci Coe, Jessica M. Smith
Summary: The aim of this study was to evaluate the effect of concomitant use of fluconazole and direct oral anticoagulants (DOACs) on bleeding risk. The study found that patients receiving a DOAC with fluconazole did not have a significantly increased risk for bleeding at 30 days compared to those receiving a DOAC alone after adjusting for confounding variables.
Article
Medical Laboratory Technology
Gavin T. Buckley, Ber Murphy, Niamh Fleming, Maeve P. Crowley, James V. Harte
Summary: This study evaluated the use of raw activated charcoal as an adsorbent material to minimize the interference of direct oral anticoagulants in coagulation assays. The results showed that raw activated charcoal efficiently adsorbed the anticoagulants without significantly affecting most coagulation parameters.
CLINICA CHIMICA ACTA
(2023)
Article
Education, Scientific Disciplines
Karen A. Moser, Kristi J. Smock
Summary: Direct oral anticoagulants (DOACs) can interfere with hemostasis assays, leading to inaccurate results. Preanalytic strategies, educational materials, testing algorithms, DOAC-neutralizing agents, and interpretive comments can help in correctly interpreting laboratory tests in the presence of DOACs.
HEMATOLOGY-AMERICAN SOCIETY OF HEMATOLOGY EDUCATION PROGRAM
(2021)
Article
Cardiac & Cardiovascular Systems
Yusuke Ito, Yasuhiro Maejima, Shun Nakagama, Yuka Shiheido-Watanabe, Natsuko Tamura, Tetsuo Sasano
Summary: The authors demonstrated a mechanism for attenuating atherosclerosis by administering an oral factor Xa inhibitor, RIV. This attenuation was achieved by suppressing macrophage autophagy and abrogating inflammasome activity.
JACC-BASIC TO TRANSLATIONAL SCIENCE
(2021)
Article
Pharmacology & Pharmacy
Chelsea N. Lopez, Luma Succar, Sara Varnado, Kevin R. Donahue
Summary: This study compared the impact on bleeding rates of a delayed, clinically driven strategy versus a standard per-package-insert strategy for transitioning from a direct oral anticoagulant to a parenteral anticoagulant. The primary endpoint showed a higher incidence of major bleeding in the delayed group compared to the standard group. Patients in both groups who experienced bleeding had a higher severity of illness and higher median DOAC anti-factor Xa concentrations.
JOURNAL OF CLINICAL PHARMACOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Emmanouela Kampouraki, Salah Abohelaika, Peter Avery, Tina Biss, Paul Murphy, Hilary Wynne, Farhad Kamali
Summary: Elderly patients have been shown to have a higher sensitivity to the direct oral anticoagulant rivaroxaban compared to young patients, potentially requiring lower doses for therapeutic anticoagulation.
JOURNAL OF THROMBOSIS AND THROMBOLYSIS
(2021)
Review
Medicine, General & Internal
Hyun Jin Oh, Kum Hei Ryu, Bum Joon Park, Byung-Ho Yoon
Summary: A network meta-analysis was conducted to evaluate the risk of major gastrointestinal bleeding associated with NOACs, showing varying profiles of GI bleeding risk for different NOACs. Apixaban appeared to decrease the risk compared to warfarin, while dabigatran and rivaroxaban showed increased risk in certain studies. No individual NOAC or enoxaparin was found to be associated with an increased risk of major GI bleeding compared to warfarin in venous thromboembolism or pulmonary embolism studies.
Article
Medicine, General & Internal
Aleksandra Jakimczuk, Bartlomiej Kalaska, Kamil Kaminski, Joanna Miklosz, Shin-Ichi Yusa, Dariusz Pawlak, Krzysztof Szczubialka, Andrzej Mogielnicki
Summary: This study developed a method to monitor the anticoagulant activity of DOACs in the presence of heparins using HBC and polybrene. These agents neutralized heparins and enabled accurate monitoring of DOACs' activity.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Hematology
Amanda M. Marshall, Taylor M. Trussell, Addison M. Yee, Mathew P. Malone
Summary: The study revealed that over 20% of pediatric patients in intensive care units receiving enoxaparin for VTE prophylaxis had serum anti-Xa levels consistent with therapeutic anticoagulation, with 5% achieving supratherapeutic anticoagulation levels. There was no correlation between serum anti-Xa levels and dosing frequency, body mass index, or creatinine levels, but blood urea nitrogen levels were found to have a positive association with anti-Xa levels above 0.5 units/mL. Routine monitoring of anti-Xa levels during VTE prophylaxis may be warranted to prevent unintended therapeutic anticoagulation.
THROMBOSIS RESEARCH
(2021)
Article
Cardiac & Cardiovascular Systems
Tamana Meihandoest, Jan-Dirk Studt, Adriana Mendez, Lorenzo Alberio, Pierre Fontana, Walter A. Wuillemin, Adrian Schmidt, Lukas Graf, Bernhard Gerber, Ursula Amstutz, Cedric Bovet, Thomas C. Sauter, Lars M. Asmis, Michael Nagler
Summary: In this study, a heparin-calibrated anti-Xa assay was found to accurately measure the drug concentrations of rivaroxaban, apixaban, and edoxaban, and correctly predict clinically relevant levels.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Pharmacology & Pharmacy
Yingcong Tan, Cynthia Hubbard, Holly Owens, James Pitt, Christopher Giuliano, Bradley Haan, Thomas Breeden, Dumitru Sirbu, Kelsey Pena, Trevlyn Haddox, Stephanie B. Edwin
Summary: The study aimed to provide evidence for the safety and efficacy of factor Xa inhibitors in low-body-weight patients. The results showed no significant differences in major bleeding, thromboembolism, clinically relevant nonmajor bleeding, and all-cause mortality between patients receiving factor Xa inhibitors versus warfarin. These findings are encouraging for the use of factor Xa inhibitors in low-body-weight patients.
Article
Pharmacology & Pharmacy
Ryohei Ono, Kazutaka Nishimura, Hidehisa Takahashi, Yasuhiko Hori, Kenichi Fukushima, Yoshio Kobayashi
Summary: This study measured the levels of anti-factor Xa activity (AXA), prothrombin time (PT), and activated partial thromboplastin time (APTT) in patients with venous thromboembolism (VTE) or non-valvular atrial fibrillation (NVAF) who were administered apixaban, edoxaban, and rivaroxaban. Each FXa inhibitor showed different ranges of AXA values, and higher AXA values were observed with twice-daily use compared to once-daily use. Different dosages of the inhibitors also resulted in variations in AXA values.
NAUNYN-SCHMIEDEBERGS ARCHIVES OF PHARMACOLOGY
(2023)
Article
Medicine, General & Internal
Annika Burger, Jan-Dirk Studt, Adriana Mendez, Lorenzo Alberio, Pierre Fontana, Walter A. Wuillemin, Adrian Schmidt, Lukas Graf, Bernhard Gerber, Cedric Bovet, Thomas C. Sauter, Nikolaus B. Binder, Michael Nagler
Summary: The study tested the clinical performance of a universal anti-Xa assay using an edoxaban calibrator, which accurately determined the concentrations of all anti-Xa inhibitors. The assay showed a high sensitivity and specificity in predicting drug concentrations.
Article
Hematology
Barbara Faganel Kotnik, Karin Strandberg, Marusa Debeljak, Lidija Kitanovski, Janez Jazbec, Majda Benedik-Dolnicar, Alenka Trampus Bakija
BLOOD COAGULATION & FIBRINOLYSIS
(2020)
Review
Hematology
Richard A. Marlar, Karin Strandberg, Midori Shima, Dorothy M. Adcock
EUROPEAN JOURNAL OF HAEMATOLOGY
(2020)
Article
Nutrition & Dietetics
Urban Alehagen, J. Alexander, J. Aaseth, A. Larsson, T. L. Lindahl
EUROPEAN JOURNAL OF NUTRITION
(2020)
Article
Biotechnology & Applied Microbiology
Jonas Holm, Ingemar Cederholm, Urban Alehagen, Tomas L. Lindahl, Zoltan Szabo
Article
Hematology
Andreas Hillarp, Karin Strandberg, Kerstin M. Gustafsson, Tomas L. Lindahl
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2020)
Article
Cell Biology
Anna Holm, Eva Swahn, Sofia Sederholm Lawesson, Kerstin M. Gustafsson, Magnus Janzon, Lena Jonasson, Tomas L. Lindahl, Joakim Alfredsson
Summary: In patients with myocardial infarction, women have a significantly higher rate of in-hospital bleeding events compared to men, although there were no significant differences in platelet aggregation between the sexes. The results do not support excess dosing of anti-platelet drugs as a major explanation for the increased bleeding risk in women.
Article
Hematology
Cecilia Augustsson, Eva Norstrom, Vivian Lind, Myriam Martin, Jan Astermark, Karin Strandberg
Summary: The study validated the monitoring of different FVIII products on Atellica Coag, showing good correlation and acceptable bias between CSA-1 and OSA. There was a clear dose-response relationship between thrombin generation parameters and products.
Article
Nutrition & Dietetics
Urban Alehagen, Jan Aaseth, Tomas L. Lindahl, Anders Larsson, Jan Alexander
Summary: Supplementation with selenium and coenzyme Q(10) can reduce D-dimer levels and the risk of cardiovascular mortality. The study results demonstrate that supplementation can prevent an increase in D-dimer, lower cardiovascular mortality, and reveal important associations between inflammation, endothelial function, and cardiovascular risk.
Article
Medical Laboratory Technology
Karin Strandberg, Cecilia Augustsson
Summary: This study evaluated the analytical performance of the Atellica COAG 360 analyzer in diagnosing bleeding disorders in a specialized coagulation laboratory. The results showed that the analyzer performed as expected and was equivalent to the BCS-XP in determining coagulation parameters, making it suitable for accurate diagnosis of bleeding disorders.
JOURNAL OF CLINICAL LABORATORY ANALYSIS
(2022)
Article
Cardiac & Cardiovascular Systems
Mikael Lund, Ankit S. Macwan, Kjersti Tunstromer, Tomas L. Lindahl, Niklas Boknas
Summary: The study found that heparin and bivalirudin have different and complementary inhibitory effects on the activation of PAR1 and PAR4 by thrombin. Heparin inhibits PAR4-mediated platelet activation, while bivalirudin inhibits signaling from both receptors but leads to delayed PAR4-mediated platelet activation, resulting in a strong prothrombotic response.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2021)
Article
Hematology
Niklas Boknas, Cia Laine, Andreas Hillarp, Ankit S. Macwan, Kerstin M. Gustafsson, Tomas L. Lindahl, Margareta Holmstrom
Summary: In this study, laboratory markers were used to characterize hemostatic function in COVID-19 patients. The incidence of death and venous thromboembolism in COVID-19 positive patients was significantly higher compared to COVID-19 negative patients. Elevated levels of von Willebrand factor and fibrinogen were observed in COVID-19 positive patients. In addition, abnormalities in specific hemostatic markers were associated with increased mortality in COVID-19 positive patients, particularly in cases with combined defects in markers of fibrinolysis and coagulation.
THROMBOSIS RESEARCH
(2022)
Article
Hematology
Myriam Martin, Cecilia Augustsson, Vivian Lind, Riam Al-Sabti, My Chi Lam, Nadine G. Andersson, Karin Strandberg
Summary: The xFLI method, based on Luminex xMAP fluorescence-immunoassay, is more sensitive and reproducible than ELISA and CBA for detecting anti-FVIII antibodies in patients with haemophilia A. It can detect both functional inhibitors and non-neutralising antibodies accurately. The overall concordance between xFLI and ELISA was 82.1% and xFLI and CBA was 77.9%.
Article
Cell Biology
Kjersti Tunstromer, Lars Faxalv, Pia Larsson, Tomas L. Lindahl, Niklas Boknas
Summary: Pharmacological inhibition of the platelet ADP-receptor P2Y(12) is important in preventing atherothrombotic events. Our study compared the effects of two different P2Y(12) inhibitors and found that one had a slower but significant platelet inhibitory effect. Additionally, we observed that inhibited platelets gradually accumulated at the periphery of the thrombus.
Article
Hematology
Cecilia Augustsson, Eva Norstrom, Nadine Gretenkort Andersson, Eva Zetterberg, Jan Astermark, Karin Strandberg
RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS
(2020)