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. 2017 Apr;33(2):117-121.
doi: 10.1016/j.joa.2016.07.011. Epub 2016 Aug 12.

Trends in physiological coagulation factors in Japanese patients receiving novel oral anticoagulants

Tomoyuki Nagao  1 , Hiroshi Hunakubo  1 , Mayu Suzuki  1 , Takashi Kataoka  1 , Satoshi Okumura  1 , Norihiro Shinoda  1 , Ken Harada  1 , Bunichi Kato  1 , Masataka Kato  1 , Nobuyuki Marui  1 , Shinichi Sakai  1 , Tetsuya Amano  2 , Toyoaki Murohara  3
Affiliations

Trends in physiological coagulation factors in Japanese patients receiving novel oral anticoagulants

Tomoyuki Nagao et al. J Arrhythm. 2017 Apr.

Abstract

Background: Little is known about physiological anticoagulation effects via antithrombin III (AT III) and protein C/S (PC/PS) in patients using new oral anticoagulants (NOACs).

Methods: We evaluated 120 consecutive patients with non-valvular atrial fibrillation (AF) receiving NOACs. Patients were randomly divided into three groups: a dabigatran group (DG, N=40), a rivaroxaban group (RG, N=40) or an apixaban group (AG, N=40). A warfarin group (WG, N=40) was matched with NOAC groups for age, sex and type of AF during the same time period. Blood samples were obtained in pretreatment, trough and peak phases to measure the activity of physiological coagulation inhibitors, including AT III and PC/PS or thrombus formation markers such as D-dimer and thrombin-antithrombin complex (TAT).

Results: D-dimer, TAT and AT III values for the NOAC groups were equivalent in the peak and trough phases. PC/PS activity in both phases was equally maintained in the pretreatment phase in the NOAC groups, while the activity in the WG was significantly suppressed in steady state. Moreover, no differences in trends for PC/PS activity were observed among NOAC groups.

Conclusions: PC/PS activity was constant in both peak and trough phases in the patients on NOACs compared with activity of those on warfarin. In addition, there was no difference in the findings among NOACs.

Keywords: Antithrombin III; Atrial fibrillation; Novel oral anticoagulant; Protein C/S.

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Figures

Fig. 1.
Fig. 1
Trends in D dimer, TAT in patients for each anticoagulant group in the pretreatment, peak, and trough phase. A dotted line shows the value in the WG. DG, dabigatran group; RG, rivaroxaban group; AG, apixaban group; WG, warfarin group; TAT, thrombin–antithrombin complex.
See this image and copyright information in PMC

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