Observational studyBlood advances2024
More early bleeds associated with high baseline direct oral anticoagulant levels in atrial fibrillation: the MAS study.
Observational study in Blood advances, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03803579 (Baseline DOAC Measurement in Non Valvular Atrial Fibrillation Patients and Incidence of Bleeding or Thromboembolic Complications During Follow-up), which is not on this map. Cited by 13 papers.
What it found
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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.
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.
Baseline DOAC Measurement in Non Valvular Atrial Fibrillation Patients and Incidence of Bleeding or Thromboembolic Complications During Follow-up: a Prospective, Multicenter, Observational Study. The MAS (Measure And See) Study
Who cites it
13 citing papers in PubMed.
- Assessing the efficacy of a single-cycle measurement and adjustment strategy for direct oral anticoagulants in frail older patients: rationale and design of the DOAC-FRAIL randomized controlled trial.Research and practice in thrombosis and haemostasis · 2026Article
- Implementing anticoagulation stewardship: the use of a dedicated mobile phone 'app' in the experience of the Italian Federation of Anticoagulation linics (FCSA).Journal of thrombosis and thrombolysis · 2026Article
- Outcomes of non-valvular atrial fibrillation elderly patients maintained on VKAs' treatment compared to patients switched to DOACs: results from the STARTInternal and emergency medicine · 2026Article
- Direct Oral Anticoagulant Levels at Time of Elective Surgery.JAMA network open · 2026Article
- Therapeutic Drug Monitoring of Direct Oral Anticoagulants and Its Association with Clinical Outcomes: A Systematic Review and Meta-Analysis.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Diagnostic Performance of a DOAC Urine Dipstick in Obese Outpatients with Atrial Fibrillation: Comparison with Plasma Concentrations.Journal of clinical medicine · 2026Article
- Relevance and limitations of clinical follow-up in a pharmacokinetic study on direct oral anticoagulants.Frontiers in pharmacology · 2026Article
- Direct oral anticoagulants as secondary prophylaxis of venous thromboembolism in paroxysmal nocturnal hemoglobinuria: an Italian monocentric experience.Journal of thrombosis and thrombolysis · 2025Article
- Is Laboratory Monitoring Useful in DOAC Management?Mediterranean journal of hematology and infectious diseases · 2025Article
- Direct oral anticoagulants measurement: when is it necessary?Blood transfusion = Trasfusione del sangue · 2025Article
- Comparative Investigation of Thromboelastometry and Thrombin Generation for Patients Receiving Direct Oral Anticoagulants or Vitamin K Antagonists.Diagnostics (Basel, Switzerland) · 2024Article
- The wonders of anticoagulation.Frontiers in cardiovascular medicine · 2024Article
- Oral Anticoagulants in Women: What's the Difference? A Narrative Review.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
Corrections and comments
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Authors and funding
22 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
abstractTreatment with direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) is effective and safe. However, bleeding complications still occur. Whether DOAC level measurement may further improve treatment efficacy and safety is still an open issue. In the "Measure and See" study, venous blood was collected 15-30 days after DOAC initiation in patients with AF who were then followed up for 1 year to record the occurrence of major and clinically relevant nonmajor bleeding. DOAC plasma levels were measured in 1 laboratory, and results were kept blind to patients and treating doctors. Trough DOAC levels were assessed in 1657 patients (957 [57.7%] and 700 patients treated with standard and low-dose, respectively). Fifty bleeding events were recorded during 1606 years of follow-up (3.11% pt/yrs). Fifteen bleeding events (4.97% pt/yrs) occurred in patients with C-trough standardized values in the highest activity class (>0.50), whereas 35 events (2.69% pt/yrs) occurred in those with values in the 2 lower classes (≤0.50, P = .0401). Increasing DOAC levels and low-dose DOAC use were associated with increased bleeding risk in the first 3 months of treatment. Overall, 19% of patients receiving low doses had standardized values in the highest class. More bleeding occurred in patients on low (4.3% pt/yrs) vs standard (2.2% pt/yrs; P = .0160) dose DOAC. Early measurement of DOAC levels in patients with AF identified many individuals with high levels despite the low doses use and had more bleeding risk during the first 3 months of treatment. This trial was registered at www.ClinicalTrials.gov as #NCT03803579.
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