liu.seSearch for publications in DiVA
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
More efficient reversal of dabigatran inhibition of coagulation by activated prothrombin complex concentrate or recombinant factor VIIa than by four-factor prothrombin complex concentrate
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences.
Novo Nordisk AS, Denmark.
Show others and affiliations
2015 (English)In: Thrombosis Research, ISSN 0049-3848, E-ISSN 1879-2472, Vol. 135, no 3, 544-547 p.Article in journal (Refereed) Published
Abstract [en]

The number of patients on antithrombotic treatment due to atrial fibrillation and venous thromboembolism is increasing fast due to an aging population. A growing proportion will be treated with novel oral anticoagulants, the first in clinical use was the direct oral thrombin inhibitor dabigatran (Pradaxa (R)). A small percentage of the patients on dabigatran will experience serious bleeding or be in need of urgent surgery. The aim of this study was to test the effects of different hemostatic agents in potentially reversing the anticoagulant effects in vitro in blood or platelet-rich plasma (PRP) spiked with dabigatran. Whole blood or PRP was spiked with the active substance dabigatran, 200 mu g/L. We measured clotting time being induced by 1.4 pmol/L tissue factor using the instrument ReoRox2 (TM) and initial clot growth velocity from a tissue factor covered surface using the instrument Thrombodynamics Analyzer T-2 (TM). Dabigatran prolonged clotting time 5-fold but reduced clot growth velocity only slightly. The reversing effects of prothrombin complex concentrates (PCC), activated PCC (APCC) and recombinant activated factor VII (rFVIIa) were then tested. APCC (1.8 U/mL) reduced the prolonged clotting time by 1/3, rFVIIa (2 mu g/L) only slightly (n = 10-20). The reduction was not significant using Mann-Whitney test but significant using t-test with Bonferronis correction for multiple comparisons, whereas PCC (0.56 U/mL) had no effect on clotting time. APCC doubled initial clot growth velocity, although even more in the absence of dabigatran. In conclusion, APCC and rFVIIa, but not PCC, seem to reverse, at least partially, some effects of dabigatran on coagulation parameters. Systematic evaluation of case reports, registries and, ultimately, randomized clinical trials are needed to elucidate potential benefit for patients. (C) 2014 Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Elsevier , 2015. Vol. 135, no 3, 544-547 p.
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-115816DOI: 10.1016/j.thromres.2014.12.019ISI: 000349633800019PubMedID: 25596769OAI: oai:DiVA.org:liu-115816DiVA: diva2:796840
Note

Funding Agencies|Boehringer-Ingelheim; County Council of Ostergotland

Available from: 2015-03-20 Created: 2015-03-20 Last updated: 2017-12-04

Open Access in DiVA

fulltext(577 kB)152 downloads
File information
File name FULLTEXT01.pdfFile size 577 kBChecksum SHA-512
9827a22c389197563d10e7ce88d7d21bf724a8bd6010c211b7f6cb381d65e0e0a4a9fb306e1dbaba04a5bb91c759e769f9ccd149bc717e1c0139a3456271cbad
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMed

Authority records BETA

Lindahl, TomasWallstedt, MariaGustafsson, Kerstin

Search in DiVA

By author/editor
Lindahl, TomasWallstedt, MariaGustafsson, Kerstin
By organisation
Division of Microbiology and Molecular MedicineFaculty of Health SciencesDepartment of Clinical ChemistryFaculty of Medicine and Health Sciences
In the same journal
Thrombosis Research
Clinical Medicine

Search outside of DiVA

GoogleGoogle Scholar
Total: 152 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 122 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf