Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Oct 12:15:27.
doi: 10.1186/s12959-017-0150-4. eCollection 2017.

Comparison of three different anti-Xa assays in major orthopedic surgery patients treated with direct oral anticoagulant

Makoto Ikejiri  1 , Hideo Wada  2   3 , Shine Tone  4 , Hiroki Wakabayashi  4 , Masahiro Hasegawa  4 , Takeshi Matsumoto  5 , Naoki Fujimoto  2 , Norikazu Yamada  6 , Masaaki Ito  6 , Kaname Nakatani  1 , Akihiro Sudo  4
Affiliations

Comparison of three different anti-Xa assays in major orthopedic surgery patients treated with direct oral anticoagulant

Makoto Ikejiri et al. Thromb J. .

Abstract

Background: Measurement of edoxaban plasma concentration has been gathering attention in major orthopedic surgery patients receiving edoxaban for the prevention of venous thromboembolism (VTE).

Methods: The anti-Xa activity was measured one hour after edoxaban intake using 3 different assays in 200 patients after major orthopedic surgery.

Results: The anti-Xa activities on Day 8 were significantly higher than those on Day 4 and those on Day 4 were significantly higher than those on Day 1. The anti-Xa activities in two assays closely correlated with each other, but the other anti-Xa assay did not correlated with other two assays. The anti-Xa activities as detected in the three Xa assays were significantly higher in the patients without deep vein thrombosis (DVT) than in those with DVT on Day 4. Additionally, there were no significant differences in the anti-Xa activities of assays A, B and C between patients with and without massive bleeding (MB) on Days 1, 4, 8 and 15.

Conclusion: The results of this study suggest that anti-Xa level could be predictive of the risk of VTE, but not of the risk of massive bleeding.

Keywords: Anti-Xa activity; DOAC; Deep vein thrombosis (DVT); Orthopedic surgery; Prophylaxis.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the Human Ethics Review Committee of the Mie University School of Medicine, and a signed consent form was obtained from each subject. This study was faithfully carried out in accordance with the principles of the Declaration of Helsinki.

Consent for publication

A signed consent form was obtained from each subject.

Competing interests

The three different Anti-Xa assays used in this study were provided by Sekisui Medical Co. Ltd., Stago and Instrumentation Laboratory.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The anti-Xa activity (A), (B) and (C) in orthopedic patients treated with edoxaban during TKA or THA. The anti-Xa activities of A kit (a), B kit (b) and C kit (c) in orthopedic patients treated with edoxaban on Days 1, 4, 8 and 15. ***, p < 0.001; **, p < 0.01; *, p < 0.05
Fig. 2
Fig. 2
Correlation between the anti-Xa activities of A and B assay (a), A and C assay (b) and B and C assay (c)
Fig. 3
Fig. 3
The anti-Xa activity in orthopedic patients with and without DVT treated with edoxaban during TKA or THA. The anti-Xa activities of A kit (a), B kit (b) and C kit (c) in orthopedic patients treated with edoxaban on Day 1, 4, 8 and 15. ***, p < 0.001; **, p < 0.01; *, p < 0.05
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Geerts WH, Heit JA, Clagett P, Pineo GF, Colwell CW, Anderson FA, Jr, et al. Prevention of venous thromboembolism. Chest. 2001;119:S132–S175. doi: 10.1378/chest.119.1_suppl.132S. - DOI - PubMed
    1. Piovella F, Wang CJ, Lu H, Lee K, Lee LH, Lee WC, et al. AIDA investigators.: Deep-vein thrombosis rates after major orthopedic surgery in Asia. An epidemiological study based on postoperative screening with centrally adjudicated bilateral venography. J Thromb Haemost. 2005;3:2664–2670. doi: 10.1111/j.1538-7836.2005.01621.x. - DOI - PubMed
    1. Geerts WH, Pineo GF, Heit JA, Bergqvist D, Lassen MR, Colwell CW, et al. Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest. 2004;126:338S–400S. doi: 10.1378/chest.126.3_suppl.338S. - DOI - PubMed
    1. van der Hulle T, Dronkers CE, Huisman MV, Klok FA. Current standings in diagnostic management of acute venous thromboembolism: still rough around the edges. Blood Rev. 2015; (in press) - PubMed
    1. Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG, et al. VTE impact assessment Group in Europe (VITAE): venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007;98:756–764. - PubMed

LinkOut - more resources