Abstract
Background: Measuring anti-Xa activity (AXA) has been reported as useful for predicting future risk of hemorrhagic and ischemic events in stroke patients taking direct factor Xa inhibitors. We evaluated AXA levels of rivaroxaban or apixaban in acute stroke patients with non-valvular atrial fibrillation. Methods and Results: This was a single-center, prospective, observational study. Consecutive patients with acute ischemic stroke or transient ischemic attack who were admitted within 7 days of onset and started taking rivaroxaban or apixaban for NVAF between January 2012 and April 2017 were enrolled. AXA was measured at 2 time points: just before (AXAtrough) and 4 h after (AXApeak) taking rivaroxaban or apixaban on the 2nd day or later of administration. Of 156 patients taking rivaroxaban, hemorrhagic events occurred in 13. Patients with hemorrhagic events had higher AXApeak than those without [median (interquartile range): 1.93 (1.11–3.75) vs. 1.35 (0.80–2.00) IU/mL; P<0.01]. Multivariable-adjusted Cox models showed that AXApeak was independently related to the incidence of hemorrhagic events. Of 169 patients taking apixaban, hemorrhagic events occurred in 11. Patients with hemorrhagic events had higher AXAtrough [2.78 (1.90–3.53) vs. 1.42 (0.93–2.08) IU/mL, P<0.01] and AXApeak [4.05 (3.44–4.72) vs. 2.43 (1.79–3.35) IU/mL, P<0.01] than those without. Both AXAtrough and AXApeak were independently related to the incidence of hemorrhagic events. Conclusions: In these patients who started rivaroxaban or apixaban early after stroke, AXA levels in the early period were related to future hemorrhagic events.
| Original language | English |
|---|---|
| Pages (from-to) | 2872-2879 |
| Number of pages | 8 |
| Journal | Circulation Journal |
| Volume | 82 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - Jan 1 2018 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
Cite this
Anti-xa activity and event risk in patients with direct factor xa inhibitors initiated early after stroke. / Wada, Shinichi; Toyoda, Kazunori; Sato, Shoichiro; Matsuki, Takayuki; Okata, Takuya; Kumamoto, Masaya; Tagawa, Naoki; Inoue, Manabu; Okamoto, Akira; Ihara, Masafumi; Kitazono, Takanari; Miyata, Toshiyuki; Koga, Masatoshi.
In: Circulation Journal, Vol. 82, No. 11, 01.01.2018, p. 2872-2879.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Anti-xa activity and event risk in patients with direct factor xa inhibitors initiated early after stroke
AU - Wada, Shinichi
AU - Toyoda, Kazunori
AU - Sato, Shoichiro
AU - Matsuki, Takayuki
AU - Okata, Takuya
AU - Kumamoto, Masaya
AU - Tagawa, Naoki
AU - Inoue, Manabu
AU - Okamoto, Akira
AU - Ihara, Masafumi
AU - Kitazono, Takanari
AU - Miyata, Toshiyuki
AU - Koga, Masatoshi
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Measuring anti-Xa activity (AXA) has been reported as useful for predicting future risk of hemorrhagic and ischemic events in stroke patients taking direct factor Xa inhibitors. We evaluated AXA levels of rivaroxaban or apixaban in acute stroke patients with non-valvular atrial fibrillation. Methods and Results: This was a single-center, prospective, observational study. Consecutive patients with acute ischemic stroke or transient ischemic attack who were admitted within 7 days of onset and started taking rivaroxaban or apixaban for NVAF between January 2012 and April 2017 were enrolled. AXA was measured at 2 time points: just before (AXAtrough) and 4 h after (AXApeak) taking rivaroxaban or apixaban on the 2nd day or later of administration. Of 156 patients taking rivaroxaban, hemorrhagic events occurred in 13. Patients with hemorrhagic events had higher AXApeak than those without [median (interquartile range): 1.93 (1.11–3.75) vs. 1.35 (0.80–2.00) IU/mL; P<0.01]. Multivariable-adjusted Cox models showed that AXApeak was independently related to the incidence of hemorrhagic events. Of 169 patients taking apixaban, hemorrhagic events occurred in 11. Patients with hemorrhagic events had higher AXAtrough [2.78 (1.90–3.53) vs. 1.42 (0.93–2.08) IU/mL, P<0.01] and AXApeak [4.05 (3.44–4.72) vs. 2.43 (1.79–3.35) IU/mL, P<0.01] than those without. Both AXAtrough and AXApeak were independently related to the incidence of hemorrhagic events. Conclusions: In these patients who started rivaroxaban or apixaban early after stroke, AXA levels in the early period were related to future hemorrhagic events.
AB - Background: Measuring anti-Xa activity (AXA) has been reported as useful for predicting future risk of hemorrhagic and ischemic events in stroke patients taking direct factor Xa inhibitors. We evaluated AXA levels of rivaroxaban or apixaban in acute stroke patients with non-valvular atrial fibrillation. Methods and Results: This was a single-center, prospective, observational study. Consecutive patients with acute ischemic stroke or transient ischemic attack who were admitted within 7 days of onset and started taking rivaroxaban or apixaban for NVAF between January 2012 and April 2017 were enrolled. AXA was measured at 2 time points: just before (AXAtrough) and 4 h after (AXApeak) taking rivaroxaban or apixaban on the 2nd day or later of administration. Of 156 patients taking rivaroxaban, hemorrhagic events occurred in 13. Patients with hemorrhagic events had higher AXApeak than those without [median (interquartile range): 1.93 (1.11–3.75) vs. 1.35 (0.80–2.00) IU/mL; P<0.01]. Multivariable-adjusted Cox models showed that AXApeak was independently related to the incidence of hemorrhagic events. Of 169 patients taking apixaban, hemorrhagic events occurred in 11. Patients with hemorrhagic events had higher AXAtrough [2.78 (1.90–3.53) vs. 1.42 (0.93–2.08) IU/mL, P<0.01] and AXApeak [4.05 (3.44–4.72) vs. 2.43 (1.79–3.35) IU/mL, P<0.01] than those without. Both AXAtrough and AXApeak were independently related to the incidence of hemorrhagic events. Conclusions: In these patients who started rivaroxaban or apixaban early after stroke, AXA levels in the early period were related to future hemorrhagic events.
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U2 - 10.1253/circj.CJ-18-0506
DO - 10.1253/circj.CJ-18-0506
M3 - Article
C2 - 30210082
AN - SCOPUS:85055495945
VL - 82
SP - 2872
EP - 2879
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 11
ER -