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The treatment effect of rivaroxaban on clot characteristics in patients who present acutely with first time deep vein thrombosis

Vanessa Evans, Matthew Lawrence, Janet Whitley, C. Johns, Suresh Pillai, Karl Hawkins Orcid Logo, K. Power, K. Morris, Rhodri Williams Orcid Logo, Adrian Evans Orcid Logo

Clinical Hemorheology and Microcirculation, Volume: 80, Issue: 2, Pages: 139 - 151

Swansea University Authors: Vanessa Evans, Matthew Lawrence, Janet Whitley, Suresh Pillai, Karl Hawkins Orcid Logo, Rhodri Williams Orcid Logo, Adrian Evans Orcid Logo

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DOI (Published version): 10.3233/ch-201030

Abstract

BACKGROUND: The acute vascular disease deep vein thrombosis (DVT) requires oral anticoagulants to prevent progression. Monitoring therapeutic efficacy of direct oral anticoagulants (DOAC), including rivaroxaban, is problematic as no reliable test is available. Advances in rheometry have led to the d...

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Published in: Clinical Hemorheology and Microcirculation
ISSN: 1386-0291 1875-8622
Published: IOS Press 2022
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URI: https://cronfa.swan.ac.uk/Record/cronfa56606
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2022-04-07T12:09:37.6553143</datestamp><bib-version>v2</bib-version><id>56606</id><entry>2021-03-30</entry><title>The treatment effect of rivaroxaban on clot characteristics in patients who present acutely with first time deep vein thrombosis</title><swanseaauthors><author><sid>a0506225f2491303811176ddf571d03e</sid><ORCID/><firstname>Vanessa</firstname><surname>Evans</surname><name>Vanessa Evans</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>262d0cae7663ded863d6e2de15757f3c</sid><firstname>Matthew</firstname><surname>Lawrence</surname><name>Matthew Lawrence</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>bda7069a6ac3481b27c9986c9bc51e49</sid><ORCID/><firstname>Janet</firstname><surname>Whitley</surname><name>Janet Whitley</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>f567f8d5db61d62ef08e811676fd8430</sid><firstname>Suresh</firstname><surname>Pillai</surname><name>Suresh Pillai</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>77c39404a9a98c6e2283d84815cba053</sid><ORCID>0000-0003-0174-4151</ORCID><firstname>Karl</firstname><surname>Hawkins</surname><name>Karl Hawkins</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>642bf793695f412ed932f1ea4d9bc3f1</sid><ORCID>0000-0002-6912-5288</ORCID><firstname>Rhodri</firstname><surname>Williams</surname><name>Rhodri Williams</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>21761f6eb805546a561c9f036e85405b</sid><ORCID>0000-0002-0814-5162</ORCID><firstname>Adrian</firstname><surname>Evans</surname><name>Adrian Evans</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2021-03-30</date><deptcode>PMSC</deptcode><abstract>BACKGROUND: The acute vascular disease deep vein thrombosis (DVT) requires oral anticoagulants to prevent progression. Monitoring therapeutic efficacy of direct oral anticoagulants (DOAC), including rivaroxaban, is problematic as no reliable test is available. Advances in rheometry have led to the development of a functional coagulation biomarker using Gel Point (GP) analysis which assesses clot structure formation. The biomarker measures incipient clot formation time (TGP) and quantifies fibrin clot structure in terms of fractal dimension (df).OBJECTIVE: This study aimed to investigate clot structure formation in first time DVT and the effect of rivaroxaban treatment.METHODS: This prospective observational cohort study measured the GP and standard laboratory markers at three sample points: pre-treatment and at 20 and 60 days following 15mg BD and 20mg OD rivaroxaban respectively. RESULTS: Forty DVT patients (mean age 64 years [SD&#xB1;14.8]; 23 males, 17 female) were recruited. The results show that DVT vs non-DVT patients did not have a significantly different GP profile (df: 1.72&#xB1;0.06 vs 1.70&#xB1;0.06 and TGP: 267&#xB1;68sec vs 262&#xB1;73sec) with both within the defined healthy index. In addition, rivaroxaban therapy increased TGP to 392s (&#xB1;135s) after 20 days, and subsequently increased to 395s (&#xB1;194s) at 60 days but did not significantly increase df (from 1.69&#xB1;0.05 to 1.71&#xB1;0.06). CONCLUSIONS: The results indicate in this cohort of DVT patients there was no underlying hypercoagulable effect as determined by gel point analysis. Furthermore, the anticoagulant effect of rivaroxaban prolonged clotting, suggesting a protective effect against clot formation, without significantly reducing clot microstructural properties.</abstract><type>Journal Article</type><journal>Clinical Hemorheology and Microcirculation</journal><volume>80</volume><journalNumber>2</journalNumber><paginationStart>139</paginationStart><paginationEnd>151</paginationEnd><publisher>IOS Press</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1386-0291</issnPrint><issnElectronic>1875-8622</issnElectronic><keywords>Rivaroxaban, coagulation inhibitors, venous thrombosis, clot structure, biomarkers</keywords><publishedDay>17</publishedDay><publishedMonth>2</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-02-17</publishedDate><doi>10.3233/ch-201030</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PMSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2022-04-07T12:09:37.6553143</lastEdited><Created>2021-03-30T16:39:36.4590656</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Vanessa</firstname><surname>Evans</surname><orcid/><order>1</order></author><author><firstname>Matthew</firstname><surname>Lawrence</surname><order>2</order></author><author><firstname>Janet</firstname><surname>Whitley</surname><orcid/><order>3</order></author><author><firstname>C.</firstname><surname>Johns</surname><order>4</order></author><author><firstname>Suresh</firstname><surname>Pillai</surname><order>5</order></author><author><firstname>Karl</firstname><surname>Hawkins</surname><orcid>0000-0003-0174-4151</orcid><order>6</order></author><author><firstname>K.</firstname><surname>Power</surname><order>7</order></author><author><firstname>K.</firstname><surname>Morris</surname><order>8</order></author><author><firstname>Rhodri</firstname><surname>Williams</surname><orcid>0000-0002-6912-5288</orcid><order>9</order></author><author><firstname>Adrian</firstname><surname>Evans</surname><orcid>0000-0002-0814-5162</orcid><order>10</order></author></authors><documents><document><filename>56606__19665__32820538f6b540a4afc79213a019fa82.pdf</filename><originalFilename>56606.pdf</originalFilename><uploaded>2021-04-16T17:36:56.6741414</uploaded><type>Output</type><contentLength>673991</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2022-04-07T12:09:37.6553143 v2 56606 2021-03-30 The treatment effect of rivaroxaban on clot characteristics in patients who present acutely with first time deep vein thrombosis a0506225f2491303811176ddf571d03e Vanessa Evans Vanessa Evans true false 262d0cae7663ded863d6e2de15757f3c Matthew Lawrence Matthew Lawrence true false bda7069a6ac3481b27c9986c9bc51e49 Janet Whitley Janet Whitley true false f567f8d5db61d62ef08e811676fd8430 Suresh Pillai Suresh Pillai true false 77c39404a9a98c6e2283d84815cba053 0000-0003-0174-4151 Karl Hawkins Karl Hawkins true false 642bf793695f412ed932f1ea4d9bc3f1 0000-0002-6912-5288 Rhodri Williams Rhodri Williams true false 21761f6eb805546a561c9f036e85405b 0000-0002-0814-5162 Adrian Evans Adrian Evans true false 2021-03-30 PMSC BACKGROUND: The acute vascular disease deep vein thrombosis (DVT) requires oral anticoagulants to prevent progression. Monitoring therapeutic efficacy of direct oral anticoagulants (DOAC), including rivaroxaban, is problematic as no reliable test is available. Advances in rheometry have led to the development of a functional coagulation biomarker using Gel Point (GP) analysis which assesses clot structure formation. The biomarker measures incipient clot formation time (TGP) and quantifies fibrin clot structure in terms of fractal dimension (df).OBJECTIVE: This study aimed to investigate clot structure formation in first time DVT and the effect of rivaroxaban treatment.METHODS: This prospective observational cohort study measured the GP and standard laboratory markers at three sample points: pre-treatment and at 20 and 60 days following 15mg BD and 20mg OD rivaroxaban respectively. RESULTS: Forty DVT patients (mean age 64 years [SD±14.8]; 23 males, 17 female) were recruited. The results show that DVT vs non-DVT patients did not have a significantly different GP profile (df: 1.72±0.06 vs 1.70±0.06 and TGP: 267±68sec vs 262±73sec) with both within the defined healthy index. In addition, rivaroxaban therapy increased TGP to 392s (±135s) after 20 days, and subsequently increased to 395s (±194s) at 60 days but did not significantly increase df (from 1.69±0.05 to 1.71±0.06). CONCLUSIONS: The results indicate in this cohort of DVT patients there was no underlying hypercoagulable effect as determined by gel point analysis. Furthermore, the anticoagulant effect of rivaroxaban prolonged clotting, suggesting a protective effect against clot formation, without significantly reducing clot microstructural properties. Journal Article Clinical Hemorheology and Microcirculation 80 2 139 151 IOS Press 1386-0291 1875-8622 Rivaroxaban, coagulation inhibitors, venous thrombosis, clot structure, biomarkers 17 2 2022 2022-02-17 10.3233/ch-201030 COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University 2022-04-07T12:09:37.6553143 2021-03-30T16:39:36.4590656 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Vanessa Evans 1 Matthew Lawrence 2 Janet Whitley 3 C. Johns 4 Suresh Pillai 5 Karl Hawkins 0000-0003-0174-4151 6 K. Power 7 K. Morris 8 Rhodri Williams 0000-0002-6912-5288 9 Adrian Evans 0000-0002-0814-5162 10 56606__19665__32820538f6b540a4afc79213a019fa82.pdf 56606.pdf 2021-04-16T17:36:56.6741414 Output 673991 application/pdf Accepted Manuscript true true eng
title The treatment effect of rivaroxaban on clot characteristics in patients who present acutely with first time deep vein thrombosis
spellingShingle The treatment effect of rivaroxaban on clot characteristics in patients who present acutely with first time deep vein thrombosis
Vanessa Evans
Matthew Lawrence
Janet Whitley
Suresh Pillai
Karl Hawkins
Rhodri Williams
Adrian Evans
title_short The treatment effect of rivaroxaban on clot characteristics in patients who present acutely with first time deep vein thrombosis
title_full The treatment effect of rivaroxaban on clot characteristics in patients who present acutely with first time deep vein thrombosis
title_fullStr The treatment effect of rivaroxaban on clot characteristics in patients who present acutely with first time deep vein thrombosis
title_full_unstemmed The treatment effect of rivaroxaban on clot characteristics in patients who present acutely with first time deep vein thrombosis
title_sort The treatment effect of rivaroxaban on clot characteristics in patients who present acutely with first time deep vein thrombosis
author_id_str_mv a0506225f2491303811176ddf571d03e
262d0cae7663ded863d6e2de15757f3c
bda7069a6ac3481b27c9986c9bc51e49
f567f8d5db61d62ef08e811676fd8430
77c39404a9a98c6e2283d84815cba053
642bf793695f412ed932f1ea4d9bc3f1
21761f6eb805546a561c9f036e85405b
author_id_fullname_str_mv a0506225f2491303811176ddf571d03e_***_Vanessa Evans
262d0cae7663ded863d6e2de15757f3c_***_Matthew Lawrence
bda7069a6ac3481b27c9986c9bc51e49_***_Janet Whitley
f567f8d5db61d62ef08e811676fd8430_***_Suresh Pillai
77c39404a9a98c6e2283d84815cba053_***_Karl Hawkins
642bf793695f412ed932f1ea4d9bc3f1_***_Rhodri Williams
21761f6eb805546a561c9f036e85405b_***_Adrian Evans
author Vanessa Evans
Matthew Lawrence
Janet Whitley
Suresh Pillai
Karl Hawkins
Rhodri Williams
Adrian Evans
author2 Vanessa Evans
Matthew Lawrence
Janet Whitley
C. Johns
Suresh Pillai
Karl Hawkins
K. Power
K. Morris
Rhodri Williams
Adrian Evans
format Journal article
container_title Clinical Hemorheology and Microcirculation
container_volume 80
container_issue 2
container_start_page 139
publishDate 2022
institution Swansea University
issn 1386-0291
1875-8622
doi_str_mv 10.3233/ch-201030
publisher IOS Press
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description BACKGROUND: The acute vascular disease deep vein thrombosis (DVT) requires oral anticoagulants to prevent progression. Monitoring therapeutic efficacy of direct oral anticoagulants (DOAC), including rivaroxaban, is problematic as no reliable test is available. Advances in rheometry have led to the development of a functional coagulation biomarker using Gel Point (GP) analysis which assesses clot structure formation. The biomarker measures incipient clot formation time (TGP) and quantifies fibrin clot structure in terms of fractal dimension (df).OBJECTIVE: This study aimed to investigate clot structure formation in first time DVT and the effect of rivaroxaban treatment.METHODS: This prospective observational cohort study measured the GP and standard laboratory markers at three sample points: pre-treatment and at 20 and 60 days following 15mg BD and 20mg OD rivaroxaban respectively. RESULTS: Forty DVT patients (mean age 64 years [SD±14.8]; 23 males, 17 female) were recruited. The results show that DVT vs non-DVT patients did not have a significantly different GP profile (df: 1.72±0.06 vs 1.70±0.06 and TGP: 267±68sec vs 262±73sec) with both within the defined healthy index. In addition, rivaroxaban therapy increased TGP to 392s (±135s) after 20 days, and subsequently increased to 395s (±194s) at 60 days but did not significantly increase df (from 1.69±0.05 to 1.71±0.06). CONCLUSIONS: The results indicate in this cohort of DVT patients there was no underlying hypercoagulable effect as determined by gel point analysis. Furthermore, the anticoagulant effect of rivaroxaban prolonged clotting, suggesting a protective effect against clot formation, without significantly reducing clot microstructural properties.
published_date 2022-02-17T04:11:40Z
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score 11.013148

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