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Apixaban enhances endogenous fibrinolysis in patients with atrial fibrillation

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In a prospective cross-sectional analysis, we compared endogenous fibrinolysis in NVAF patients (n = 180) taking aspirin, warfarin, or apixaban. In a prospective longitudinal study, patients were tested before and after apixaban (n = 80). Endogenous fibrinolysis was assessed using the Global Thrombosis Test (GTT) and thromboelastography (TEG). Endogenous fibrinolysis [measured by GTT lysis time (LT)] was shorter on apixaban compared with warfarin or aspirin [median 1850 (IQR 1591–2300) vs. 2758 (2014–3502) vs. 2135 (1752–2463) s, P < 0.0001]. Among TEG indices, a small but significant difference in clot lysis time (CLT) was observed [apixaban 60.0 (45.0–61.0) vs. warfarin 61.0 (57.0–62.0) vs. aspirin 61.0 (59.0–61.0) min, P = 0.036]. Apixaban improved endogenous fibrinolysis
measured using the GTT [LT pre-treatment 2204 (1779–2738) vs. on-treatment 1882 (1607–2374) s, P = 0.0003], but not by using TEG. Change in LT (DLT) with apixaban correlated with baseline LT (r = 0.77, P < 0.0001). There was weak correlation between DLT and DCLT in response to apixaban (r = 0.28, P = 0.02) and between onapixaban LT and CLT (r = 0.25, P¼0.022).

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: .,

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Language

English

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NONE

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Subject(s)

Apixaban
Endogenous fibrinolysis
Thrombosis

Specific Detail Info

Europace (2019) 21, 1297–1306

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