K. Pukite1, I. Urtane1, I. Pupkevica1, I. Cernevska1, O. Boicuka1, J. Meisters1, D. Straupmane1, A. Lejnieks1, A. Strelnieks1, O. Kalejs1 (1Riga LV)
The aim of this study was to analyze the necessary of coagulation tests for AF patients with high cardiovascular risk in clinical practice.
Design and methods. Quantitative, analytic, cross-sectional clinical study, during the period from April 2018 to February 2019, was performed at Pauls Stradins Clinical University Hospital, Cardiology Centre of Latvia. There were collected data about patients with non-valvular AFib under anticoagulative therapy ≥3 months, defined as a high-risk group by CHA2DS2-VASc score – from score 2. Concentration was measured using anti-Xa assay un direct thrombin inhibitors’ assay. Data were analyzed using SPSS.
Results. There were collected data about 7 patients of whom 85.7% (n=6) were male; the mean age was 66.3 (SD±5.77) years. The mean CHA2DS2-VASc score was 2.86 (SD±1.57). The most common comorbidies were arterial hypertension and coronary artery disease (42.86%; 3), stroke (42.86%; 3) and diabetes mellitus (28.57%; 2). 71.43% used rivaroxaban. Increased risk of possible drug-drug interactions most frequently was with statins (71.43%; 5), proton pump inhibitors and anti-inflammatory drugs (42.86%; 3). 2/3 of patients were taking ≥1 drug with potential pharmacokinetics interactions increasing the risk of bleeding. The average Cmax drug concentration in blood was lower than expected, reaching 216.28 ng/ml and decreasing about 67.17% within 24 hours.
Conclusion. Rivaroxaban measurements varied from 27 to 407 ng/ml (median value 143.64 ng/ml) within 24 hours. Three patients had higher-than-expected rivaroxaban levels.