Effects of Rivaroxaban on Biomarkers of Coagulation and Inflammation: A Post Hoc Analysis of the X-VeRT Trial.

Kirchhof, Paulus and Ezekowitz, Michael D and Purmah, Yanish and Schiffer, Sonja and Meng, Isabelle L and Camm, A John and Hohnloser, Stefan H and Schulz, Anke and Wosnitza, Melanie and Cappato, Riccardo (2020) Effects of Rivaroxaban on Biomarkers of Coagulation and Inflammation: A Post Hoc Analysis of the X-VeRT Trial. TH open : companion journal to thrombosis and haemostasis, 4 (1). e20-e32. ISSN 2512-9465. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using your UHB Athens login IDs.

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Official URL: http://europepmc.org/article/PMC/6978177

Abstract

This X-VeRT (eXplore the efficacy and safety of once-daily oral riVaroxaban for the prevention of caRdiovascular events in patients with nonvalvular aTrial fibrillation scheduled for cardioversion) substudy evaluated the effects of treatment with rivaroxaban or a vitamin-K antagonist (VKA) on levels of biomarkers of coagulation (D-dimer, thrombin-antithrombin III complex [TAT] and prothrombin fragment [F1.2]) and inflammation (high sensitivity C-reactive protein [hs-CRP] and high-sensitivity interleukin-6 [hs-IL-6]) in patients with atrial fibrillation (AF) who were scheduled for cardioversion and had not received adequate anticoagulation at baseline (defined as, in the 21 days before randomization: no oral anticoagulant; international normalized ratio <2.0 with VKA treatment; or <80% compliance with non-VKA oral anticoagulant treatment).  Samples for biomarker analysis were taken at baseline (  = 958) and treatment completion (42 days after cardioversion;  = 918). The influence of clinical characteristics on baseline biomarker levels and the effect of treatment on changes in biomarker levels were evaluated using linear and logistic models.  Baseline levels of some biomarkers were significantly associated with type of AF (D-dimer and hs-IL-6) and with history of congestive heart failure (hs-CRP, D-dimer, and hs-IL-6). Rivaroxaban and VKA treatments were associated with reductions from baseline in levels of D-dimer (-32.3 and -37.6%, respectively), TAT (-28.0 and -23.1%, respectively), hs-CRP (-12.5 and -17.9%, respectively), and hs-IL-6 (-9.2 and -9.8%, respectively). F1.2 levels were reduced from baseline in patients receiving a VKA (-53.0%) but not in those receiving rivaroxaban (2.7%).  Anticoagulation with rivaroxaban reduced levels of key inflammation and coagulation biomarkers to a similar extent as VKAs, with the exception of F1.2. Further investigation to confirm the value of these biomarkers in patients with AF is merited.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using your UHB Athens login IDs.
Subjects: QY Clinical pathology
QZ Pathology. Oncology
WG Cardiovascular system. Cardiology
Divisions: Emergency Services > Cardiology
Planned IP Care > Oncology and Clinical Haematology
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Depositing User: Mr Muneeb Liaquat
Date Deposited: 31 Jan 2020 13:01
Last Modified: 31 Jan 2020 13:01
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2813

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