Reversal of rivaroxaban-induced alterations on hemostasis by different coagulation factor concentrates – in vitro studies with steady and circulating human blood.

摘要: Background:Despite the good safety of rivaroxaban, there is limited information on strategies for urgent reversal its antihemostatic effects.Methods and Results:Alterations hemostasis induced by rivaroxaban (230 ng/ml) were assessed using several tests applied to steady circulating human blood. Effects thrombin generation (TG) thromboelastometry (TEM) parameters measured. Modifications in platelet adhesive, aggregating procoagulant activities evaluated studies with The potential prothrombin complex concentrates (PCCs; 50 IU/kg), activated PCCs (aPCCs; 75 or recombinant factor VIIa (rFVIIa; 270 μg/kg) was evaluated. Impairment TG corrected different (aPCC≥PCC>rFVIIa). Prolonged clotting times reduced clot firmness caused TEM improved (rFVIIa≥aPCC>PCC). Rivaroxaban significantly platelets fibrin interactions damaged vascular surfaces perfusion studies. While alterations favourably counteracted rFVIIa aPCCs, reductions formation only partially restored (rFVIIa>aPCC≥PCC).Conclusions:Rivaroxaban-induced coagulation measured through assays performed under static conditions easily reversed concentrates. Studies flow revealed that these normalized action platelets, formation; although later case, levels not pre-treatment value. (Circ J 2015; 79: 331–338)