The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker

Lawrence, Matthew; Evans, Vanessa; Whitley, Janet; Pillai, Suresh; Williams, Rhodri; Coulson, James; Krishnan, Manju; Slade, Peter; Power, Kieron; Morris, Roger H.K.; Evans, Adrian

doi:10.1002/prp2.937

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The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker

Matthew Lawrence, Vanessa Evans, Janet Whitley, Suresh Pillai, Rhodri Williams

, James Coulson, Manju Krishnan, Peter Slade, Kieron Power, Roger H.K. Morris, Adrian Evans

Pharmacology Research and Perspectives, Volume: 10, Issue: 2

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

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DOI (Published version): 10.1002/prp2.937

Abstract

Atrial fibrillation (AF) is a major risk factor for stroke. We aim to characterize AF patients and the effects of apixaban therapy in terms of clot microstructure using gel point analysis, a novel biomarker. Seventy-eight patients were included in the study, 50 Stroke with AF (AF-S), and 28 AF witho...

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Published in:	Pharmacology Research and Perspectives
ISSN:	2052-1707 2052-1707
Published:	Wiley 2022
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We aim to characterize AF patients and the effects of apixaban therapy in terms of clot microstructure using gel point analysis, a novel biomarker. Seventy-eight patients were included in the study, 50 Stroke with AF (AF-S), and 28 AF without stroke (AF). Pre- and post-anticoagulation samples were collected: gel point (GP) analysis was performed to obtain (i) TGP (the time taken to reach the GP or the clot formation time) and (ii) df , the fractal dimension of the clot, a quantification of clot fibrin microstructure at the GP. At baseline, the AF-S group had a df = 1.70 (±0.05) and TGP = 306 (±73 s). The AF group had a df = 1.70 ± 0.05 and TGP = 346 ± 78 s, showing a significantly shortened TGP in the stroke group (p = .008). For both groups, apixaban significantly prolonged TGP, p = .005, but resulted in no change in df. Apixaban prolonged clotting time while having no significant impact on the blood's ability to form stable clots (no change in df ). 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spelling	2022-10-31T17:58:03.4488737 v2 60554 2022-07-20 The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker 262d0cae7663ded863d6e2de15757f3c Matthew Lawrence Matthew Lawrence true false a0506225f2491303811176ddf571d03e Vanessa Evans Vanessa Evans true false bda7069a6ac3481b27c9986c9bc51e49 Janet Whitley Janet Whitley true false f567f8d5db61d62ef08e811676fd8430 Suresh Pillai Suresh Pillai true false 642bf793695f412ed932f1ea4d9bc3f1 0000-0002-6912-5288 Rhodri Williams Rhodri Williams true false 21761f6eb805546a561c9f036e85405b 0000-0002-0814-5162 Adrian Evans Adrian Evans true false 2022-07-20 BMS Atrial fibrillation (AF) is a major risk factor for stroke. We aim to characterize AF patients and the effects of apixaban therapy in terms of clot microstructure using gel point analysis, a novel biomarker. Seventy-eight patients were included in the study, 50 Stroke with AF (AF-S), and 28 AF without stroke (AF). Pre- and post-anticoagulation samples were collected: gel point (GP) analysis was performed to obtain (i) TGP (the time taken to reach the GP or the clot formation time) and (ii) df , the fractal dimension of the clot, a quantification of clot fibrin microstructure at the GP. At baseline, the AF-S group had a df = 1.70 (±0.05) and TGP = 306 (±73 s). The AF group had a df = 1.70 ± 0.05 and TGP = 346 ± 78 s, showing a significantly shortened TGP in the stroke group (p = .008). For both groups, apixaban significantly prolonged TGP, p = .005, but resulted in no change in df. Apixaban prolonged clotting time while having no significant impact on the blood's ability to form stable clots (no change in df ). This indicates that apixaban provides protection from the formation of thrombi by reducing clotting kinetics. Journal Article Pharmacology Research and Perspectives 10 2 Wiley 2052-1707 2052-1707 Anticoagulation; apixaban; cerebrovascular disease; clot microstructure; gel point and fractal analysis 1 4 2022 2022-04-01 10.1002/prp2.937 COLLEGE NANME Biomedical Sciences COLLEGE CODE BMS Swansea University This work was supported by a grant under the ERISTA funding stream which is funded under the Alliance program of both Bristol- Myers Squibb and Pfizer. 2022-10-31T17:58:03.4488737 2022-07-20T12:51:53.2727955 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Matthew Lawrence 1 Vanessa Evans 2 Janet Whitley 3 Suresh Pillai 4 Rhodri Williams 0000-0002-6912-5288 5 James Coulson 6 Manju Krishnan 7 Peter Slade 8 Kieron Power 9 Roger H.K. Morris 10 Adrian Evans 0000-0002-0814-5162 11 60554__24672__72d02f3108854aa5929f45170bdf0c7d.pdf 60554.pdf 2022-07-20T12:55:58.0634300 Output 943998 application/pdf Version of Record true © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title	The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker
spellingShingle	The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker Matthew Lawrence Vanessa Evans Janet Whitley Suresh Pillai Rhodri Williams Adrian Evans
title_short	The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker
title_full	The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker
title_fullStr	The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker
title_full_unstemmed	The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker
title_sort	The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker
author_id_str_mv	262d0cae7663ded863d6e2de15757f3c a0506225f2491303811176ddf571d03e bda7069a6ac3481b27c9986c9bc51e49 f567f8d5db61d62ef08e811676fd8430 642bf793695f412ed932f1ea4d9bc3f1 21761f6eb805546a561c9f036e85405b
author_id_fullname_str_mv	262d0cae7663ded863d6e2de15757f3c_*_Matthew Lawrence a0506225f2491303811176ddf571d03e__Vanessa Evans bda7069a6ac3481b27c9986c9bc51e49__Janet Whitley f567f8d5db61d62ef08e811676fd8430__Suresh Pillai 642bf793695f412ed932f1ea4d9bc3f1__Rhodri Williams 21761f6eb805546a561c9f036e85405b_*_Adrian Evans
author	Matthew Lawrence Vanessa Evans Janet Whitley Suresh Pillai Rhodri Williams Adrian Evans
author2	Matthew Lawrence Vanessa Evans Janet Whitley Suresh Pillai Rhodri Williams James Coulson Manju Krishnan Peter Slade Kieron Power Roger H.K. Morris Adrian Evans
format	Journal article
container_title	Pharmacology Research and Perspectives
container_volume	10
container_issue	2
publishDate	2022
institution	Swansea University
issn	2052-1707 2052-1707
doi_str_mv	10.1002/prp2.937
publisher	Wiley
college_str	Faculty of Medicine, Health and Life Sciences
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department_str	Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description	Atrial fibrillation (AF) is a major risk factor for stroke. We aim to characterize AF patients and the effects of apixaban therapy in terms of clot microstructure using gel point analysis, a novel biomarker. Seventy-eight patients were included in the study, 50 Stroke with AF (AF-S), and 28 AF without stroke (AF). Pre- and post-anticoagulation samples were collected: gel point (GP) analysis was performed to obtain (i) TGP (the time taken to reach the GP or the clot formation time) and (ii) df , the fractal dimension of the clot, a quantification of clot fibrin microstructure at the GP. At baseline, the AF-S group had a df = 1.70 (±0.05) and TGP = 306 (±73 s). The AF group had a df = 1.70 ± 0.05 and TGP = 346 ± 78 s, showing a significantly shortened TGP in the stroke group (p = .008). For both groups, apixaban significantly prolonged TGP, p = .005, but resulted in no change in df. Apixaban prolonged clotting time while having no significant impact on the blood's ability to form stable clots (no change in df ). This indicates that apixaban provides protection from the formation of thrombi by reducing clotting kinetics.
published_date	2022-04-01T04:18:45Z
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The effects of apixaban on clot characteristics in atrial fibrillation: A novel pharmacodynamic biomarker

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