血栓动力学试验评估心房颤动患者直接口服抗凝药物血栓形成的风险

IF 0.3 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Rational Pharmacotherapy in Cardiology Pub Date : 2022-11-03 DOI:10.20996/1819-6446-2022-09-07

Z. A. Gebekova, I. Ivanov, A. Asambayeva, A. Skripka, A. Sokolova, D. Napalkov, T. Vuimo

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引用次数: 3

摘要

的目标。应用血栓动力学试验评价不同直接口服抗凝剂(DOACs)治疗心房颤动(AF)患者的血栓特征。材料和方法。对100例服用不同doac的阵发性和永久性房颤患者进行血栓动力学试验，根据用药说明书进行剂量选择。为了进行分析，在常规DOACs剂量摄入(谷浓度)之前，采集新鲜枸橼酸无血小板血浆样本。采用R软件包对统计数据进行处理。所有患者在纳入本研究前均无血栓或出血史。DOACs残留浓度下进行的血栓动力学试验各项参数基本在参考值范围内，即在凝血正常范围内:空间凝块生长速率(V) - 26.56 (25.0;29.2 μm/min，到凝块开始生长的时间(lag) - 1.05 (0.85;1.27) min，初始空间血块生长速率(Vi) - 44.3±7.7 μm/min，静止空间血块生长速率(Vst) - 26.5 (24.9;28.4 μm/min，凝块尺寸(CS) - 999.7 (912.9;1084.7) μm，凝块密度(D) - 22883.1±3199.9 arb。单位。D在女性中似乎更高[22947.7 (21477.5;22947.7) vs男性[22124.8 (19722.8;22124.8)， p=0.035]，慢性心力衰竭患者的lag显著增高[1.2 (1.0;1.2) vs 1.0 (0.8;1.0), p = 0.008)。肌酐水平与flag参数、肾小球滤过率(GFR)和凝块密度之间存在相关性。随着血肌酐水平的升高和GFR的降低，lag参数升高(p值为0.038);随着GFR的升高，血凝块密度降低(p值0.005)。DOACs残留浓度的血栓动力学试验参数均在参考值范围内，表明各DOACs抗凝效果最佳。在抗凝剂残留浓度下获得的正常凝血数据与之前使用其他方法获得的doac安全性和有效性数据一致。需要有临床终点的进一步研究来评估该方法的临床价值。

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Thrombodynamics Test in Assessing the Risk of Thrombus Formation in Patients with Atrial Fibrillation Taking Direct Oral Anticoagulants

Aim. To evaluate thrombus characteristics in patients with atrial fibrillation (AF) taking different direct oral anticoagulants (DOACs) using Thrombodynamics test.Materials and methods. Thrombodynamics test was performed in 100 patients with paroxysmal and permanent forms of AF taking different DOACs, dose choice was done in accordance with the instructions for drugs use. For analysis samples of fresh citrated platelet-free plasma were taken just before regular DOACs dose intake (trough concentration). Statistical data processing was carried out using R software packages.Results. All patients had no history of thrombosis or bleeding before inclusion in this study. All parameters of Thrombodynamics test taken at residual concentration of DOACs were in general within reference values, that is in the area of normal coagulation: spatial clot growth rate (V) – 26.56 (25.0; 29.2) μm/min, the time to the start of clot growth (Tlag) – 1.05 (0.85; 1.27) min, initial spatial clot growth rate (Vi) – 44.3±7.7 μm/min, stationary spatial clot growth rate (Vst) – 26.5 (24.9; 28.4) μm/min, clot size (CS) – 999.7 (912.9; 1084.7) μm, clot density (D) – 22883.1±3199.9 arb. units. D was appeared to be higher in women [22947.7 (21477.5; 22947.7) vs men [22124.8 (19722.8; 22124.8), p=0.035] and Tlag was significantly higher in patients with chronic heart failure [1.2 (1.0; 1.2) vs 1.0 (0.8; 1.0), p=0.008]. A correlation was found between level of creatinine and Tlag parameter, glomerular filtration rate (GFR) and clot density. With an increase in the level of creatinine in the blood and a decrease in GFR, respectively, there was an increase in Tlag parameter (p-value 0.038); with an increase in GFR, clot density decrease (p-value 0.005).Conclusion. All parameters of Thrombodynamics test on residual concentration of DOACs were within reference values that indicated optimal anticoagulant effect of all DOACs. The obtained data of normal coagulation at the residual concentration of the anticoagulant are consistent with the previously obtained data on the safety and effectiveness of DOACs using other methods. Further studies with clinical end points are needed to assess the clinical value of this method.

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来源期刊

Rational Pharmacotherapy in Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

1.00

自引率

50.00%

发文量

审稿时长

6 weeks

期刊介绍： The primary goals of the Journal are consolidation of information on scientific and practical achievements in pharmacotherapy and prevention of cardiovascular diseases and continuing education of cardiologists and internists. The scientific concept of the edition suggests the publication of information on current achievements in cardiology, the results of national and international clinical trials. The Journal publishes original articles on the results of clinical trials designed to study the effectiveness and safety of drugs, analysis of clinical practice and its compliance with national and international recommendations, expert s’ opinions on a wide range of cardiology issues, associated conditions and clinical pharmacology. There is a heading “Preventive cardiology and public health” in the Journal to stimulate research interest in this highly demanded area. Memories of the outstanding people in medicine including cardiology, which are of great interest to historians of medicine, are published in "Our Mentors” heading.