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Evaluación de la anticoagulación con rivaroxaban, en pacientes con fibrilación auricular no valvular de reciente diagnóstico / Evaluation of oral anticoagulation with rivaroxaban, in patients with new onset non valvular atrial fibrillation
Neira, Víctor; Corbalán, Ramón; Pereira, Jaime; Panes, Olga; Garayar, Bernardita; Aizman, Andrés; Llevaneras, Silvana; Villarroel, Luis.
  • Neira, Víctor; Pontificia Universidad Católica de Chile. División de Enfermedades Cardiovasculares. Santiago. CL
  • Corbalán, Ramón; Pontificia Universidad Católica de Chile. División de Enfermedades Cardiovasculares. Santiago. CL
  • Pereira, Jaime; Pontificia Universidad Católica de Chile. División de Enfermedades Cardiovasculares. Santiago. CL
  • Panes, Olga; Pontificia Universidad Católica de Chile. División de Enfermedades Cardiovasculares. Santiago. CL
  • Garayar, Bernardita; Pontificia Universidad Católica de Chile. División de Enfermedades Cardiovasculares. Santiago. CL
  • Aizman, Andrés; Pontificia Universidad Católica de Chile. División de Enfermedades Cardiovasculares. Santiago. CL
  • Llevaneras, Silvana; Pontificia Universidad Católica de Chile. División de Enfermedades Cardiovasculares. Santiago. CL
  • Villarroel, Luis; Pontificia Universidad Católica de Chile. División de Enfermedades Cardiovasculares. Santiago. CL
Rev. méd. Chile ; 144(9): 1103-1111, set. 2016. graf, tab
Artículo en Español | LILACS | ID: biblio-830618
ABSTRACT

Background:

Atrial fibrillation (AF) generates a hypercoagulable state with an increased thrombin generation and raised levels of thrombin-antithrombin complexes, which results in a high risk of stroke and thromboembolism.

Aim:

To evaluate the anticoagulant effect of rivaroxaban by anti-Xa factor activity and its correlation with thrombin-antithrombin complexes, thrombin generation and prothrombin time in patients newly diagnosed with non-valvular AF. Patients and

Methods:

Prospective study in patients with indication of anticoagulation. Demographic variables, cardiovascular risk factors, CHA2DS2-VASc and HAS-BLED scores were recorded. Blood samples were taken at baseline, at 3 and 24 hours after the administration of the drug and at 30 days. Rivaroxaban levels, anti-Xa activity, prothrombin time, thrombin generation and plasma levels of thrombin-antithrombin complexes were determined.

Results:

We studied 20 patients aged 76.3 ± 8.0 years (60% female) with a CHA2DS2-VASc score > 2 points. The anti-Xa factor activity correlated with rivaroxaban plasma levels at 3 hours (r = 0.61, p < 0.01), at 24 hours (r = 0.85, p < 0.01) and at 30 days (r = 0.99, p < 0.01), with prothrombin time at 3 hours (r = -0.86, p = 0.019) and at 30 days (r = -0.63, p = 0.02) and with a sustained decrease in thrombin generation at 30 days of follow-up (r = -0.74, p < 0.01). There was no correlation with thrombin-antithrombin complexes (r = -0.02, p = 0.83).

Conclusions:

Rivaroxaban consistently inhibited the mild pro-coagulant state found in newly diagnosed non-valvular AF patients through the first 24 hours and this effect was maintained at 30 days. Plasma levels of the drug correlated with anti-Xa factor activity, thrombin generation and prothrombin time
Asunto(s)


Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Péptido Hidrolasas / Fibrilación Atrial / Trombina / Factor Xa / Antitrombina III / Inhibidores del Factor Xa / Rivaroxabán Tipo de estudio: Estudio diagnóstico / Estudio observacional / Factores de riesgo Límite: Anciano / Aged80 / Femenino / Humanos / Masculino Idioma: Español Revista: Rev. méd. Chile Asunto de la revista: Medicina Año: 2016 Tipo del documento: Artículo País de afiliación: Chile Institución/País de afiliación: Pontificia Universidad Católica de Chile/CL

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Texto completo: Disponible Índice: LILACS (Américas) Asunto principal: Péptido Hidrolasas / Fibrilación Atrial / Trombina / Factor Xa / Antitrombina III / Inhibidores del Factor Xa / Rivaroxabán Tipo de estudio: Estudio diagnóstico / Estudio observacional / Factores de riesgo Límite: Anciano / Aged80 / Femenino / Humanos / Masculino Idioma: Español Revista: Rev. méd. Chile Asunto de la revista: Medicina Año: 2016 Tipo del documento: Artículo País de afiliación: Chile Institución/País de afiliación: Pontificia Universidad Católica de Chile/CL