Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study

Background Hypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Sunnersjö, Lotta [verfasserIn] Ymén, Isak [verfasserIn] Schött, Ulf [verfasserIn] Hillarp, Andreas [verfasserIn] Undén, Johan [verfasserIn] Kander, Thomas [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2024

Schlagwörter:	Rivaroxaban ROTEM Hypothermia Acidosis Coagulation Anticoagulant

Anmerkung:	© The Author(s) 2024

Übergeordnetes Werk:	Enthalten in: Thrombosis journal - BioMed Central, 2003, 22(2024), 1 vom: 18. Okt.
Übergeordnetes Werk:	volume:22 ; year:2024 ; number:1 ; day:18 ; month:10

Links:	Volltext

DOI / URN:	10.1186/s12959-024-00661-0

Katalog-ID:	SPR057886210

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520			\|a Background Hypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing. Results In total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels. Conclusions The combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis. Trial registration The study was retrospectively registered 2023-03-01 at ClinTrials.gov with NCT05669313.
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allfields	10.1186/s12959-024-00661-0 doi (DE-627)SPR057886210 (SPR)s12959-024-00661-0-e DE-627 ger DE-627 rakwb eng 610 VZ Sunnersjö, Lotta verfasserin aut Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Hypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing. Results In total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels. Conclusions The combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis. Trial registration The study was retrospectively registered 2023-03-01 at ClinTrials.gov with NCT05669313. Rivaroxaban (dpeaa)DE-He213 ROTEM (dpeaa)DE-He213 Hypothermia (dpeaa)DE-He213 Acidosis (dpeaa)DE-He213 Coagulation (dpeaa)DE-He213 Anticoagulant (dpeaa)DE-He213 Ymén, Isak verfasserin aut Schött, Ulf verfasserin aut Hillarp, Andreas verfasserin aut Undén, Johan verfasserin aut Kander, Thomas verfasserin aut Enthalten in Thrombosis journal BioMed Central, 2003 22(2024), 1 vom: 18. Okt. (DE-627)369082982 (DE-600)2118392-2 1477-9560 nnns volume:22 year:2024 number:1 day:18 month:10 https://dx.doi.org/10.1186/s12959-024-00661-0 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_72 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4029 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4116 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4155 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2024 1 18 10
spelling	10.1186/s12959-024-00661-0 doi (DE-627)SPR057886210 (SPR)s12959-024-00661-0-e DE-627 ger DE-627 rakwb eng 610 VZ Sunnersjö, Lotta verfasserin aut Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Hypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing. Results In total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels. Conclusions The combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis. Trial registration The study was retrospectively registered 2023-03-01 at ClinTrials.gov with NCT05669313. Rivaroxaban (dpeaa)DE-He213 ROTEM (dpeaa)DE-He213 Hypothermia (dpeaa)DE-He213 Acidosis (dpeaa)DE-He213 Coagulation (dpeaa)DE-He213 Anticoagulant (dpeaa)DE-He213 Ymén, Isak verfasserin aut Schött, Ulf verfasserin aut Hillarp, Andreas verfasserin aut Undén, Johan verfasserin aut Kander, Thomas verfasserin aut Enthalten in Thrombosis journal BioMed Central, 2003 22(2024), 1 vom: 18. Okt. (DE-627)369082982 (DE-600)2118392-2 1477-9560 nnns volume:22 year:2024 number:1 day:18 month:10 https://dx.doi.org/10.1186/s12959-024-00661-0 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_72 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4029 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4116 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4155 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2024 1 18 10
allfields_unstemmed	10.1186/s12959-024-00661-0 doi (DE-627)SPR057886210 (SPR)s12959-024-00661-0-e DE-627 ger DE-627 rakwb eng 610 VZ Sunnersjö, Lotta verfasserin aut Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Hypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing. Results In total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels. Conclusions The combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis. Trial registration The study was retrospectively registered 2023-03-01 at ClinTrials.gov with NCT05669313. Rivaroxaban (dpeaa)DE-He213 ROTEM (dpeaa)DE-He213 Hypothermia (dpeaa)DE-He213 Acidosis (dpeaa)DE-He213 Coagulation (dpeaa)DE-He213 Anticoagulant (dpeaa)DE-He213 Ymén, Isak verfasserin aut Schött, Ulf verfasserin aut Hillarp, Andreas verfasserin aut Undén, Johan verfasserin aut Kander, Thomas verfasserin aut Enthalten in Thrombosis journal BioMed Central, 2003 22(2024), 1 vom: 18. Okt. (DE-627)369082982 (DE-600)2118392-2 1477-9560 nnns volume:22 year:2024 number:1 day:18 month:10 https://dx.doi.org/10.1186/s12959-024-00661-0 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_72 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4029 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4116 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4155 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2024 1 18 10
allfieldsGer	10.1186/s12959-024-00661-0 doi (DE-627)SPR057886210 (SPR)s12959-024-00661-0-e DE-627 ger DE-627 rakwb eng 610 VZ Sunnersjö, Lotta verfasserin aut Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Hypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing. Results In total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels. Conclusions The combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis. Trial registration The study was retrospectively registered 2023-03-01 at ClinTrials.gov with NCT05669313. Rivaroxaban (dpeaa)DE-He213 ROTEM (dpeaa)DE-He213 Hypothermia (dpeaa)DE-He213 Acidosis (dpeaa)DE-He213 Coagulation (dpeaa)DE-He213 Anticoagulant (dpeaa)DE-He213 Ymén, Isak verfasserin aut Schött, Ulf verfasserin aut Hillarp, Andreas verfasserin aut Undén, Johan verfasserin aut Kander, Thomas verfasserin aut Enthalten in Thrombosis journal BioMed Central, 2003 22(2024), 1 vom: 18. Okt. (DE-627)369082982 (DE-600)2118392-2 1477-9560 nnns volume:22 year:2024 number:1 day:18 month:10 https://dx.doi.org/10.1186/s12959-024-00661-0 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_72 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4029 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4116 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4155 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2024 1 18 10
allfieldsSound	10.1186/s12959-024-00661-0 doi (DE-627)SPR057886210 (SPR)s12959-024-00661-0-e DE-627 ger DE-627 rakwb eng 610 VZ Sunnersjö, Lotta verfasserin aut Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study 2024 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2024 Background Hypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing. Results In total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels. Conclusions The combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis. Trial registration The study was retrospectively registered 2023-03-01 at ClinTrials.gov with NCT05669313. Rivaroxaban (dpeaa)DE-He213 ROTEM (dpeaa)DE-He213 Hypothermia (dpeaa)DE-He213 Acidosis (dpeaa)DE-He213 Coagulation (dpeaa)DE-He213 Anticoagulant (dpeaa)DE-He213 Ymén, Isak verfasserin aut Schött, Ulf verfasserin aut Hillarp, Andreas verfasserin aut Undén, Johan verfasserin aut Kander, Thomas verfasserin aut Enthalten in Thrombosis journal BioMed Central, 2003 22(2024), 1 vom: 18. Okt. (DE-627)369082982 (DE-600)2118392-2 1477-9560 nnns volume:22 year:2024 number:1 day:18 month:10 https://dx.doi.org/10.1186/s12959-024-00661-0 X:SPRINGER Resolving-System kostenfrei Volltext SYSFLAG_0 GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_72 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4029 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4116 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4155 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 22 2024 1 18 10
language	English
source	Enthalten in Thrombosis journal 22(2024), 1 vom: 18. Okt. volume:22 year:2024 number:1 day:18 month:10
sourceStr	Enthalten in Thrombosis journal 22(2024), 1 vom: 18. Okt. volume:22 year:2024 number:1 day:18 month:10
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Rivaroxaban ROTEM Hypothermia Acidosis Coagulation Anticoagulant
dewey-raw	610
isfreeaccess_bool	true
container_title	Thrombosis journal
authorswithroles_txt_mv	Sunnersjö, Lotta @@aut@@ Ymén, Isak @@aut@@ Schött, Ulf @@aut@@ Hillarp, Andreas @@aut@@ Undén, Johan @@aut@@ Kander, Thomas @@aut@@
publishDateDaySort_date	2024-10-18T00:00:00Z
hierarchy_top_id	369082982
dewey-sort	3610
id	SPR057886210
language_de	englisch
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We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing. Results In total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels. Conclusions The combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis. 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author	Sunnersjö, Lotta
spellingShingle	Sunnersjö, Lotta ddc 610 misc Rivaroxaban misc ROTEM misc Hypothermia misc Acidosis misc Coagulation misc Anticoagulant Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study
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topic_title	610 VZ Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study Rivaroxaban (dpeaa)DE-He213 ROTEM (dpeaa)DE-He213 Hypothermia (dpeaa)DE-He213 Acidosis (dpeaa)DE-He213 Coagulation (dpeaa)DE-He213 Anticoagulant (dpeaa)DE-He213
topic	ddc 610 misc Rivaroxaban misc ROTEM misc Hypothermia misc Acidosis misc Coagulation misc Anticoagulant
topic_unstemmed	ddc 610 misc Rivaroxaban misc ROTEM misc Hypothermia misc Acidosis misc Coagulation misc Anticoagulant
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title	Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study
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title_full	Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study
author_sort	Sunnersjö, Lotta
journal	Thrombosis journal
journalStr	Thrombosis journal
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author_browse	Sunnersjö, Lotta Ymén, Isak Schött, Ulf Hillarp, Andreas Undén, Johan Kander, Thomas
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title_sort	synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ rotem^{®} $: a prospective observational study
title_auth	Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study
abstract	Background Hypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing. Results In total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels. Conclusions The combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis. Trial registration The study was retrospectively registered 2023-03-01 at ClinTrials.gov with NCT05669313. © The Author(s) 2024
abstractGer	Background Hypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing. Results In total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels. Conclusions The combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis. Trial registration The study was retrospectively registered 2023-03-01 at ClinTrials.gov with NCT05669313. © The Author(s) 2024
abstract_unstemmed	Background Hypothermia and acidosis individually inhibit haemostasis. We designed this study with the aim to investigate whether rivaroxaban combined with hypothermia or acidosis exhibit synergistic inhibitory effects on haemostasis using $ ROTEM^{®} $. Methods Patients with a clinical indication to start rivaroxaban treatment were prospectively included. Blood samples were collected before initiation of treatment and the day after. All blood samples were in vitro modified with respect to temperature (incubated and analysed at 28, 33, 37 and 40 degrees Celsius (°C)) and pH (6.8, 7.0, 7.2 and 7.4). The temperature and acidosis effects on the ROTEM EXTEM variables clotting time (CT), clot formation time (CFT) and alpha-angle (AA) were measured along with the individual effect of rivaroxaban on the same variables. The additive effect was calculated. The observed (potential synergistic) effects for the temperature and pH modified rivaroxaban samples on the same ROTEM variables, were registered. Differences between the additive and observed (potential synergistic) effects were analysed using matched non-parametric hypothesis testing. Results In total, 13 patients were included. Hypothermia and rivaroxaban exhibited a synergistic effect on CT at 28 °C (p = 0.0002) and at 33 °C (p = 0.0007). The same applied for acidosis at pH 6.8 (p = 0.003) and pH 7.0 (p = 0.003). There were no signs of synergistic effects of rivaroxaban and temperature or acidosis on CFT. In AA there were signs of synergism at 28 °C (p = 0,001), but not at other tested temperatures or pH levels. Conclusions The combination rivaroxaban together with hypothermia or acidosis demonstrated inhibitory synergistic effects on haemostasis. Trial registration The study was retrospectively registered 2023-03-01 at ClinTrials.gov with NCT05669313. © The Author(s) 2024
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title_short	Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study
url	https://dx.doi.org/10.1186/s12959-024-00661-0
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Synergistic effects of rivaroxaban and hypothermia or acidosis on coagulation initiation measured with $ ROTEM^{®} $: a prospective observational study

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Zugang & Verfügbarkeit

Vorhandene Bände

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