Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina.
Department of Statistics, North Carolina State University, Raleigh, North Carolina.
J Vet Emerg Crit Care (San Antonio). 2021 Jan;31(1):18-24. doi: 10.1111/vec.13011. Epub 2020 Oct 29.
To evaluate a panel of coagulation assays for their potential utility in rivaroxaban monitoring as alternatives to the rivaroxaban-specific anti-Xa activity (RIVA).
Prospective experimental study.
University research laboratory.
Five healthy neutered male Beagles.
Dogs were administered a median dose of 1.8 mg/kg rivaroxaban (range, 1.6-1.8 mg/kg) orally once daily for 2 consecutive days as part of a pharmacodynamic study. Blood was collected from a preplaced jugular catheter at time points relative to their rivaroxaban administration (0, 2, 4, 8, 24, 36, and 48 h) for measurement of RIVA, prothrombin time (PT), activated partial thromboplastin time, RapidTEG, and thrombin generation variables.
One hundred forty data points were available for analysis. There was poor correlation between RIVA and RapidTEG variables: R time (R) (min) (r = 0.554, P < 0.0001), K time (K) (min) (r = -0.204, P = 0.016), alpha angle (degrees) (r = 0.152, P = 0.073), Maximum amplitude (MA) (mm) (r = 0.106, P = 0.215), and G value (G) (dynes/s) (r = 0.108, P = 0.205). A good correlation was noted between thrombin generation variables and RIVA: lag time (min) (r = 0.827, P < 0.0001), peak (nM) (r = -0.752, P < 0.0001), and endogenous thrombin potential (nM·min) (r = -0.762, P < 0.0001). There was an excellent correlation between PT and RIVA (r = 0.915, P < 0.0001) and a good correlation between activated partial thromboplastin time and RIVA (r = 0.772, P < 0 .0001).
Of all the coagulation tests investigated, the PT correlated best with RIVA. There is potential for PT being a convenient second-line monitoring option in dogs receiving rivaroxaban, but further work is necessary to validate other PT assays. Thromboelastography performed with strong activators correlated poorly with anti-Xa activity.
评估一组凝血检测在监测利伐沙班中的潜在效用，作为利伐沙班特异性抗 Xa 活性（RIVA）的替代方法。
前瞻性实验研究。
大学研究实验室。
5 只健康去势雄性比格犬。
犬连续 2 天每天口服中位数剂量 1.8mg/kg 利伐沙班（范围 1.6-1.8mg/kg），作为药效动力学研究的一部分。在给药时间点（0、2、4、8、24、36 和 48 小时）通过预先放置的颈静脉导管采集血液，用于测量 RIVA、凝血酶原时间（PT）、活化部分凝血活酶时间、快速血栓弹力图（RapidTEG）和凝血酶生成变量。
共分析了 140 个数据点。RIVA 和 RapidTEG 变量之间相关性差：R 时间（min）（r=0.554，P<0.0001）、K 时间（min）（r=-0.204，P=0.016）、α角（degrees）（r=0.152，P=0.073）、最大振幅（mm）（r=0.106，P=0.215）和 G 值（dynes/s）（r=0.108，P=0.205）。凝血酶生成变量与 RIVA 之间存在良好相关性：延迟时间（min）（r=0.827，P<0.0001）、峰值（nM）（r=-0.752，P<0.0001）和内源性凝血酶潜能（nM·min）（r=-0.762，P<0.0001）。PT 与 RIVA 相关性极好（r=0.915，P<0.0001），活化部分凝血活酶时间与 RIVA 相关性良好（r=0.772，P<0.0001）。
在所研究的所有凝血检测中，PT 与 RIVA 相关性最佳。PT 有可能成为接受利伐沙班治疗的犬的便捷二线监测选择，但需要进一步工作来验证其他 PT 检测。使用强激活剂进行血栓弹力图与抗 Xa 活性相关性差。
