Apixaban concentration variability and relation to clinical outcomes in real-life patients with atrial fibrillation

Abstract In some clinical situations, measurements of anticoagulant effect of apixaban may be needed. We investigated the inter- and intra-individual apixaban variability in patients with atrial fibrillation and correlated these results with clinical outcome. We included 62 patients receiving either...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Alenka Mavri, Nina Vene, Mojca Božič-Mijovski, Marko Miklič, Lisbeth Söderblom, Anton Pohanka, Rickard E. Malmström, Jovan Antovic
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0924ed74aa5d49abbeb7d5aa319ba73a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:0924ed74aa5d49abbeb7d5aa319ba73a
record_format	dspace
spelling	oai:doaj.org-article:0924ed74aa5d49abbeb7d5aa319ba73a2021-12-02T18:34:20ZApixaban concentration variability and relation to clinical outcomes in real-life patients with atrial fibrillation10.1038/s41598-021-93372-92045-2322https://doaj.org/article/0924ed74aa5d49abbeb7d5aa319ba73a2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93372-9https://doaj.org/toc/2045-2322Abstract In some clinical situations, measurements of anticoagulant effect of apixaban may be needed. We investigated the inter- and intra-individual apixaban variability in patients with atrial fibrillation and correlated these results with clinical outcome. We included 62 patients receiving either 5 mg (A5, n = 32) or 2.5 mg (A2.5, n = 30) apixaban twice-daily. We collected three trough and three peak blood samples 6–8 weeks apart. Apixaban concentration was measured by liquid chromatography-tandem mass-spectrometry (LC–MS/MS) and by anti-Xa. Patients on A2.5 were older, had lower creatinine clearance, higher CHA2DS2VASc (4.7 ± 1.0 vs. 3.4 ± 1.7) and lower trough (85 ± 39 vs. 117 ± 53 ng/mL) and peak (170 ± 56 vs. 256 ± 91 ng/mL) apixaban concentrations than patients on A5 (all p < 0.01). In patients on A5, LC–MS/MS showed a significant difference between through levels and between peak levels (p < 0.01). During apixaban treatment, 21 patients suffered bleeding (2 major). There was no association between bleeding and apixaban concentrations or variability. Four patients who suffered thromboembolic event had lower peak apixaban concentrations than patients without it (159 ± 13 vs. 238 ± 88 ng/mL, p = 0.05). We concluded, that there was a significant intra- and inter-individual variability in apixaban trough and peak concentrations. Neither variability nor apixaban concentrations were associated with clinical outcomes.Alenka MavriNina VeneMojca Božič-MijovskiMarko MikličLisbeth SöderblomAnton PohankaRickard E. MalmströmJovan AntovicNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Alenka Mavri Nina Vene Mojca Božič-Mijovski Marko Miklič Lisbeth Söderblom Anton Pohanka Rickard E. Malmström Jovan Antovic Apixaban concentration variability and relation to clinical outcomes in real-life patients with atrial fibrillation
description	Abstract In some clinical situations, measurements of anticoagulant effect of apixaban may be needed. We investigated the inter- and intra-individual apixaban variability in patients with atrial fibrillation and correlated these results with clinical outcome. We included 62 patients receiving either 5 mg (A5, n = 32) or 2.5 mg (A2.5, n = 30) apixaban twice-daily. We collected three trough and three peak blood samples 6–8 weeks apart. Apixaban concentration was measured by liquid chromatography-tandem mass-spectrometry (LC–MS/MS) and by anti-Xa. Patients on A2.5 were older, had lower creatinine clearance, higher CHA2DS2VASc (4.7 ± 1.0 vs. 3.4 ± 1.7) and lower trough (85 ± 39 vs. 117 ± 53 ng/mL) and peak (170 ± 56 vs. 256 ± 91 ng/mL) apixaban concentrations than patients on A5 (all p < 0.01). In patients on A5, LC–MS/MS showed a significant difference between through levels and between peak levels (p < 0.01). During apixaban treatment, 21 patients suffered bleeding (2 major). There was no association between bleeding and apixaban concentrations or variability. Four patients who suffered thromboembolic event had lower peak apixaban concentrations than patients without it (159 ± 13 vs. 238 ± 88 ng/mL, p = 0.05). We concluded, that there was a significant intra- and inter-individual variability in apixaban trough and peak concentrations. Neither variability nor apixaban concentrations were associated with clinical outcomes.
format	article
author	Alenka Mavri Nina Vene Mojca Božič-Mijovski Marko Miklič Lisbeth Söderblom Anton Pohanka Rickard E. Malmström Jovan Antovic
author_facet	Alenka Mavri Nina Vene Mojca Božič-Mijovski Marko Miklič Lisbeth Söderblom Anton Pohanka Rickard E. Malmström Jovan Antovic
author_sort	Alenka Mavri
title	Apixaban concentration variability and relation to clinical outcomes in real-life patients with atrial fibrillation
title_short	Apixaban concentration variability and relation to clinical outcomes in real-life patients with atrial fibrillation
title_full	Apixaban concentration variability and relation to clinical outcomes in real-life patients with atrial fibrillation
title_fullStr	Apixaban concentration variability and relation to clinical outcomes in real-life patients with atrial fibrillation
title_full_unstemmed	Apixaban concentration variability and relation to clinical outcomes in real-life patients with atrial fibrillation
title_sort	apixaban concentration variability and relation to clinical outcomes in real-life patients with atrial fibrillation
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/0924ed74aa5d49abbeb7d5aa319ba73a
work_keys_str_mv	AT alenkamavri apixabanconcentrationvariabilityandrelationtoclinicaloutcomesinreallifepatientswithatrialfibrillation AT ninavene apixabanconcentrationvariabilityandrelationtoclinicaloutcomesinreallifepatientswithatrialfibrillation AT mojcabozicmijovski apixabanconcentrationvariabilityandrelationtoclinicaloutcomesinreallifepatientswithatrialfibrillation AT markomiklic apixabanconcentrationvariabilityandrelationtoclinicaloutcomesinreallifepatientswithatrialfibrillation AT lisbethsoderblom apixabanconcentrationvariabilityandrelationtoclinicaloutcomesinreallifepatientswithatrialfibrillation AT antonpohanka apixabanconcentrationvariabilityandrelationtoclinicaloutcomesinreallifepatientswithatrialfibrillation AT rickardemalmstrom apixabanconcentrationvariabilityandrelationtoclinicaloutcomesinreallifepatientswithatrialfibrillation AT jovanantovic apixabanconcentrationvariabilityandrelationtoclinicaloutcomesinreallifepatientswithatrialfibrillation
_version_	1718377842659557376

Apixaban concentration variability and relation to clinical outcomes in real-life patients with atrial fibrillation

Ejemplares similares