Evidence map›Paper›PMID 35253872›Full record

ArticleInteractive cardiovascular and thoracic surgery2022

Apixaban in a porcine model of mechanical valve thrombosis in pulmonary position-a pilot study.

Lucas Van Hoof, Isabelle Truyers, Hadewych Van Hauwermeiren, Bram Nachtergaele, Tom Langenaeken, Marc Jacquemin, Filip Rega, Peter Verhamme, Bart Meuris

Open access · hybridAbstract read
In one paragraph

Article in Interactive cardiovascular and thoracic surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Difference in coagulation systems of large animal species used in cardiovascular research: a systematic review.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025
    Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Lucas Van HoofDepartment of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.ORCID 0000-0003-3960-4568
Isabelle TruyersMedanex Clinic, Diest, Belgium.
Hadewych Van HauwermeirenMedanex Clinic, Diest, Belgium.
Bram NachtergaeleMedanex Clinic, Diest, Belgium.
Tom LangenaekenDepartment of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.
Marc JacqueminDepartment of Hemostasis in Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.
Filip RegaDepartment of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.ORCID 0000-0002-8428-2302
Peter VerhammeDepartment of Vascular Medicine and Hemostasis, University Hospitals Leuven, Leuven, Belgium.ORCID 0000-0001-8698-2858
Bart MeurisDepartment of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.ORCID 0000-0001-9176-293X
KU Leuven · BEAblynx (Belgium) · BE

Funding

Doctoral Grant Strategic Basic Research SB 1S70220NFoundation Flanders (FWO)
6 · The paper itself

Abstract

objectivesThe newest mechanical valves have low thrombogenicity, making them candidates for anticoagulation with a direct oral anticoagulant. While these drugs hold great promise to replace warfarin, clinical trials have been disappointing so far. We aimed to evaluate apixaban in a porcine model of mechanical valve thrombosis with On-X® (CryoLife) aortic valves implanted in pulmonary position.

methodsOn-X® valves were implanted in pulmonary valve position in 9 Yucatan pigs. Animals received prophylactic enoxaparin 40 mg for 1 week. Pigs in the low-dose group received 5 mg apixaban twice daily for 10 weeks. The intermediary-dose group received 5 mg twice daily for 6 weeks and then 10 mg twice daily afterwards. The high-dose group received 15 mg twice daily for 10 weeks. After sacrifice, valves were macroscopically evaluated and thrombus weight was documented.

resultsThe median weight of the 9 animals was 64.3 kg, range 52.5-70.9. In the low-dose group (2 animals), both valves showed manifest, chronic thrombosis with blocked hinges. In the intermediary-dose group, a normal functioning valve without thrombosis was seen in 2/4 animals. In the high-dose group (3 pigs), there was no valve thrombosis. No bleeding events occurred. In all animals, apixaban plasma levels were low compared to clinical target levels.

conclusionsThe pulmonary position seems to be an aggressive model for mechanical valve thrombosis in pigs. Apixaban has the potential to prevent valve thrombosis, even in these thrombogenic conditions. Detailed pharmacokinetic studies are needed to determine the ideal apixaban dosage for future experiments and to enable extrapolation to the clinical situation.

Indexed as

Heart Valve ProsthesisHeart Valve Prosthesis ImplantationThrombosisAnimalsAnticoagulantsPilot ProjectsPyrazolesPyridonesSwineAnticoagulantsapixabanPyrazolesPyridonesApixabanMechanical valveOn-XPigThrombosis

Identifiers

PMID35253872
PMCPMC9297512
OpenAlexW4214901271

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.