In vitro assessment, using thrombin generation, of the applicability of prothrombin complex concentrate as an antidote for Rivaroxaban.

摘要: Summary Background Rivaroxaban has been approved as an antithrombotic agent for prevention of venous thromboembolism with specific indications. At present no antidote is appointed and guidelines have formulated the measurement Rivaroxaban reversal. Objectives In study, we evaluated influence prothrombin complex concentrate (PCC) on anticoagulant effects measured by time (PT) thrombin generation tests (TGTs). Methods Plasma whole blood samples from healthy volunteers were spiked (up to 800 μg L−1) PCC was added these in concentration ranges used clinically reverse vitamin K antagonists. PT, endogenous potential (ETP) calibrated automated thrombography (CAT) assays performed varying tissue factor (TF) concentrations. Results Addition Rivaroxaban-spiked did not result normalization PT TGT lag time/T-Lag ETP CAT, respectively. In contrast, CAT area under curve occur. However, response addition strongly TF dependent less required reversal compared plasma. Conclusions Prothrombin does neutralize lengthening effect anticoagulated vitro; however, total could be normalized. Response different TGTs this respect assay condition dependent. Therefore, prospective studies are needed clarify which parameter describes vivo hemostasis best patients who treated PCC.