ArticleBlood transfusion = Trasfusione del sangue2022
Differential effect of direct oral anticoagulants on thrombin generation and fibrinolysis in patients with atrial fibrillation and venous thromboembolism.
Article in Blood transfusion = Trasfusione del sangue, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
8 citing papers in PubMed, 9 citations in OpenAlex.
- Antiplatelet effects of oral anticoagulants in patients with atrial fibrillation: ex-vivo studies.Journal of thrombosis and thrombolysis · 2026Article
- Autologous whole blood clot formation with actigraft in patients receiving oral anticoagulant therapy: an ex vivo feasibility study.Journal of thrombosis and thrombolysis · 2026Article
- Real-Time Imaging of Platelet-Initiated Plasma Clot Formation and Lysis Unveils Distinct Impacts of Anticoagulants.Thrombosis and haemostasis · 2025Article
- Pleiotropic Effects of Oral Anticoagulant Therapy: Is There a Difference Between VKAs and DOACs?Biomedicines · 2025Article
- Left Ventricular Pseudoaneurysm Possibly Associated with Rivaroxaban Therapy Disappeared after Cessation of Rivaroxaban: Case Report and Literature Review.Surgical case reports · 2025Article
- Ex Vivo Antiplatelet Effects of Oral Anticoagulants.Journal of cardiovascular development and disease · 2024Article
- Congruent identification of imbalanced fibrinolysis by 2 distinct clot lysis time assays.Research and practice in thrombosis and haemostasis · 2023Article
- Lupus anticoagulant testing during anticoagulation, including direct oral anticoagulants.Research and practice in thrombosis and haemostasis · 2022Review
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent reports suggest that direct oral anticoagulants (DOAC) may induce different anticoagulant and profibrinolytic responses. We performed a head-to-head comparison of the changes in thrombin generation (TG) parameters and tissue plasminogen activator (t-PA)-induced clot lysis produced by different DOAC. MATERIAL AND
methodsWe tested 137 plasma samples from patients with non-valvular atrial fibrillation (n=72) and venous thromboembolism (n=65) under treatment with apixaban (n=38), edoxaban (n=29), rivaroxaban (n=39), or dabigatran (n=31). TG was evaluated by a fluorometric assay and fibrinolysis by measuring the lysis time of clots exposed to 40 ng/mL t-PA.
resultsTrough-to-peak changes of TG parameters, along with correlation analysis, showed that all DOAC prolonged the lag-time in a concentration-dependent fashion. As for the other parameters, anti-factor Xa drugs markedly reduced the thrombin peak and velocity index but had little (rivaroxaban) or no effect on endogenous thrombin potential (ETP); dabigatran, instead, reduced ETP, weakly decreased thrombin peak and did not influence the velocity index, as also inferred from the changes in TG values after neutralisation of dabigatran with idarucizumab. Concerning the profibrinolytic effect of DOAC, intergroup comparison showed that the clot lysis time of dabigatran samples was significantly shorter than that of the apixaban and rivaroxaban samples, at both C-Trough and C-Peak. Moreover, a significant correlation between trough-to-peak changes in drug level and clot lysis time was only observed in the dabigatran group (rho=0.53). Finally, after DOAC removal by DOAC-stop, only dabigatran samples showed a significant increase in lysis time. DISCUSSION: Our data show that dabigatran inhibits TG in a different way than anti-Xa DOAC; moreover, under our conditions, only dabigatran displayed profibrinolytic activity, most likely because of its distinctive effect on the TG curve.
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