Impact of increased kidney function on clinical and biological outcomes in real-world patients treated with Direct Oral Anticoagulants
Corrochano, Mariana (Institut d'Investigació Biomèdica Sant Pau)
Acosta-Isaac, René (Institut d'Investigació Biomèdica Sant Pau)
Plaza, Melania (Institut d'Investigació Biomèdica Sant Pau)
Muñoz Diaz, Rodrigo (Intitut D'Investigacions Biomèdiques Sant Pau)
Mojal, Sergi (Institut d'Investigació Biomèdica Sant Pau)
Moret, Carla (Institut d'Investigació Biomèdica Sant Pau)
Souto, Joan Carles (Institut d'Investigació Biomèdica Sant Pau)

Data:	2022
Resum:	Background and purpose Renal excretion of direct oral anticoagulants (DOACs) varies depending on the drug. Hypothetically, an increased glomerular filtration rate (GFR) may lead to suboptimal dosing and a higher thromboembolic events incidence. However, real-world patient data do not support the theoretical risk. The aim is to analyse DOAC outcomes in patients with normal and high (≥90 mL/min) GFR, focusing on biological parameters and thrombotic/haemorrhagic events. Methods Observational prospective single-centre study and registry of patients on DOACs. Followup was 1,343 patient-years. A bivariate analysis was performed of baseline variables according to GFR (<90 mL/min vs ≥90 mL/min). Anti-Xa activity before and after drug intake (HemosIL, Liquid Anti-Xa, Werfen) was measured for edoxaban, apixaban, and rivaroxaban; diluted thrombin time for dabigatran (HEMOCLOT); and additionally, plasma concentrations in edoxaban (HemosIl, Liquid Anti-Xa suitably calibrated). Results 1,135 patients anticoagulated with DOACs were included and 152 patients with GFR ≥90 mL/min. Of 18 serious thrombotic complications during follow-up, 17 occurred in patients with GFR <90 mL/min, and 1 in a patient with GFR ≥90 mL/min. A higher incidence of complications was observed in patients with normal GFR, but the difference was not statistically significant (p>0. 05). No statistically significant differences with clinical relevance were observed between the normal or supranormal groups in anti-Xa activity or in edoxaban plasma concentrations. Conclusions There was no increased incidence of thrombotic/haemorrhagic complications in our patients treated with DOACs, including 66% treated with edoxaban, and patients with GFR ≥90 mL/ min. Likewise, drug anti-Xa activity and edoxaban plasma concentration did not seem to be influenced by GFR.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Administration, Oral ; Anticoagulants ; Atrial Fibrillation ; Dabigatran ; Factor Xa Inhibitors ; Heparin, Low-Molecular-Weight ; Humans ; Kidney ; Prospective Studies ; Pyridones ; Rivaroxaban
Publicat a:	PloS one, Vol. 17 Núm. 12 December (december 2022) , p. e0278693, ISSN 1932-6203

DOI: 10.1371/journal.pone.0278693
PMID: 36490245

11 p, 392.4 KB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut de Recerca Sant Pau
Articles > Articles de recerca
Articles > Articles publicats