Drug levels and bleeding complications in atrial fibrillation patients treated with direct oral anticoagulants

• DOI: 10.1111/jth.14457
• Publication Date: 2019-04-23T16:30:56Z
• Authors: Sophie Testa; Cristina Legnani; Emilia Antonucci; Oriana Paoletti; Claudia Dellanoce; Benilde Cosmi; Vittorio Pengo; Daniela Poli; Rossella Morandini; Roberto Testa; Armando Tripodi; Gualtiero Palareti
• Keywords: Apixaban; Oral anticoagulant

Unlabelled Box<li>•Currently, DOACs are given at fixed doses and do not require laboratory monitoring.</li><li>•Direct oral anticoagulant‐specific measurements were performed trough peak.</li><li>•Patients who developed bleeding events showed higher DOAC plasma levels peak.</li><li>•This study suggests the need of a more accurate dose assessment.</li> <h3>Background</h3> Direct anticoagulants (DOACs) administered dose. The aim was to evaluate relationship between C‐trough or C‐peak complications in patients with non‐valvular atrial fibrillation (NVAF). <h3>Methods</h3> Five hundred sixty five consecutive naive NVAF enrolled. (available 411 patients) steady state, within first month treatment. Major (MB), clinically relevant non‐major (CRNMB), minor (MinB), occurring during 1 year follow‐up after blood sampling, recorded. For each DOAC, interval subdivided into four equal classes results attributed these classes; median values also calculated. <h3>Results</h3> Two eight on apixaban, 185 dabigatran, 172 rivaroxaban. 1‐[qqqdeletezzz] follow up for all patients, we observed: 19 MB (3.36%), 6 CRNMB (1.06%), 47 MinB (8.31%). prevalence anticoagulant upper activity (II + III IV) than that lowest class. Normalized those without bleeding. <h3>Conclusions</h3> Bleeding treatment frequent among (AF) levels. In addition previous an increased risk thrombotic low levels, this seems indicate would definition their optimal therapeutic window.