The Uticaj DOAK i DOAC-REMOVE® na testove koagulacije u toku testiranja trombofilije kod bolesnika lečenih primenom DOAK

  • Mirjana Kovač University of Belgrade, Faculty of Medicine, Institute of Molecular Genetics and Genetic Engineering, Belgrade, Serbia
  • Dušica Basarić University of Belgrade, nstitute of Molecular Genetics and Genetic Engineering, Belgrade, Serbia
  • Branko Tomić Blood Transfusion Institute of Serbia, Hemostasis Department, Belgrade, Serbia
  • Maja Gvozdenov Blood Transfusion Institute of Serbia, Hemostasis Department, Belgrade, Serbia
  • Dragana Backović University of Belgrade, Faculty of Medicine, Faculty of Pharmacy, Belgrade, Serbia
  • Sanja Lalić Ćosić University of Belgrade, Faculty of Medicine, Faculty of Pharmacy, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP210217101K
Ključne reči: antikoagulansi;, krv, testovi koagulacije;, procena, istraživanja;, trombofilija.

Sažetak


Uvod/Cilj. Primena direktnih oralnih antikoagulansa (DOAK) značajno utiče na testove koagulacije. Cilj rada bio je da se proceni uticaj DOAK i DOAC-Remove® tableta (aktivni ugalj) na testove koagulacije tokom ispitivanja trombofilije. Metode. Istraživanjem, sprovedenim od januara 2019. do juna 2020. godine, obuhvaćeno je 30 bolesnika lečenih DOAK-om i testiranih na trombofiliju zbog venskog tromboembolzma (VTE). Bilo je 14 žena i 16 muškaraca, starosti od 23 do 63 godine (medijana 47,6 godina). Ispitivanje trombofilije izvršeno je upotrebom DOAC-Remove® tableta (aktivni ugalj). Upoređivani su rezultati pre i posle primene DOAC-Remove®. Rezultati. Pozitivni rezultati za lupus antikoagulantni (LA) test dobijeni su kod 20% bolesnika lečenih apiksabanom, kod 100% bolesnika lečenih dabigatranom i kod 70% lečenih rivaroksabanom, a u uzorcima posle DOAC-Remove® pozitivnost na LA dobijena je samo kod jednog bolesnika iz grupe lečnih apiksabanom. Pre primene DOAC-Remove®, rezistencija na aktivisani protein C (activated protein C resistance – APC-R) bila je merljiva kod 40% i 80% bolesnika lečenih dabigatranom, odnosno rivaroksabanom, dok je posle primene DOAC-Remove®, APC-R bila merljiva u svim slučajevima. Upoređivanjem rezultata dobijenih iz uzoraka pre i posle primene DOAC-Remove®, primećena je razlika u odnosu na sve testove vremena koagulacije izvršene razblaženim Russell-ovim zmijskim otrovom (dilute Russell’s viper venom time – dRVVT), osim dRVVT u grupi bolesnika lečenih apiksabanom. Na koagulacionu metodu za otkrivanje APC-R značajno je uticao dabigatran, a manje rivaroksaban. Zaključak. Nakon primene DOAC-Remove® tableta, DOAK su praktično inaktivisani što je omogućilo izvođenje analiza za LA i APC-R i dobijanje relevantnih rezultata testova.

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Objavljeno
2023/01/04
Broj časopisa
Vol. 79 Br. 12 (2022): Vojnosanitetski pregled
Rubrika
Originalni članak