Please use this identifier to cite or link to this item: 10.33678/cor.2019.050
Title: Methods for detection of direct oral anticoagulants and their role in clinical practice
Authors: Pukite, Katrina
Apsite, Ketija
Pupkevica, Irina
Cernevska, Ilze
Boichuk, Oksana
Meisters, Janis
Straupmane, Dagnija
Urtane, Inga
Lejnieks, Aivars
Kalejs, Oskars
Faculty of Medicine
Department of Pharmaceutical Chemistry
Department of Internal Diseases
Keywords: 3.1 Basic medicine;3.2 Clinical medicine;1.1. Scientific article indexed in Web of Science and/or Scopus database;Cardiology and Cardiovascular Medicine;SDG 3 - Good Health and Well-being
Issue Date: 2019
Citation: Pukite , K , Apsite , K , Pupkevica , I , Cernevska , I , Boichuk , O , Meisters , J , Straupmane , D , Urtane , I , Lejnieks , A & Kalejs , O 2019 , ' Methods for detection of direct oral anticoagulants and their role in clinical practice ' , Cor et Vasa , vol. 61 , no. 4 , pp. 370-376 . https://doi.org/10.33678/cor.2019.050
Abstract: Introduction: Atrial fi brillation (AF) is the most common arrhythmia that increases by age, doubles for every decade after age of 50 years and reaches about 10% patients ≥ 80 years.1 Despite direct oral anticoagulants' (DOACs') predictable pharmacokinetics and pharmacodynamics, the laboratory tests are necessary for efective and safe medical treatment, also for prediction and detection of thrombotic and bleeding events, as well as in situations when temporary discontinuation could be desirable.2 Aim: The aim of this study was to identify and analyze the need of coagulation tests for AF patients with high cardiovascular risk in clinical practice. Methods: Quantitative, analytic, cross-sectional clinical trial, during the period from October 2016 till June 2017, was performed at Center of Cardiology, Pauls Stradins Clinical University Hospital, Latvia. There were collected data about patients with non-valvular AF, under anticoagulative therapy ≥3 months, defi ned as a high-risk group by CHA2DS2-VASc score - more or equal to 2 or 3, men and women, respectively. Data were analyzed using SPSS. Results: There were collected data about 143 patients of whom 46.2% (n = 66) were male; the mean age was 69.7 (SD ± 9.9) years. About 2/3 (73.1%) of all patients the AF were longer than 1 year. The mean CHA2DS2-VASc score was 4.2 (SD ± 1.5). The most common comorbidities were arterial hypertension (65.0%; 93), chronic heart failure (48.3%; 69), coronary artery disease (32.9%; 47), diabetes mellitus (24.5%; 35), and dyslipidemia (25.9%; 37). Almost half of patients (46.2%; 66) used DOACs, 31.5% rivaroxaban and 14.7% dabigatran, respectively; furthermore, 1.4% patients used DOACs with antiaggregants. 49.7% (71) patients had increased risk of possible drug-drug interactions, most frequently with proton pump inhibitors (16.8%; 24), amiodarone (24.5%; 35), anti-inflammatory drugs (49.0%; 70). The use of DOACs and possible drug-drug interactions increases by risk score, reaching the maximum score 3 (16.1%; 23) and the mean frequent score 4.4 of 86 (60.1%) AF patients, respectively. The drug concentration in blood was lower than expected, reaching about 75.20% of Cmax. Conclusion: DOACs' usage correlates with CHA2DS2-VASc score with mean frequent score 4.4 of 86 (60.1%) AF patients, respectively. Coagulation tests were applicable more than half of patients (60.1%) to detect DOACs concentration in plasma.
Description: Publisher Copyright: © 2019, ČKS.
DOI: 10.33678/cor.2019.050
ISSN: 0010-8650
Appears in Collections:Research outputs from Pure / Zinātniskās darbības rezultāti no ZDIS Pure

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