Increased Levels of Platelets and
Endothelial-Derived Microparticles in Patients With Non-Valvular Atrial Fibrillation During Rivaroxaban Therapy.
Clin Appl Thromb Hemost 2021;
27:10760296211019465. [PMID:
34032122 PMCID:
PMC8155766 DOI:
10.1177/10760296211019465]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It is known that atrial fibrillation (AF) is associated with the procoagulant
state. Several studies have reported an increase of circulating microparticles
in AF, which may be linked to a hypercoagulable state, atrial thrombosis and
thromboembolism. We evaluated in our study alterations in both platelet (PMP,
CD42b) and endothelial-derived (EMP, CD144) microparticle levels on
anticoagulant therapy with rivaroxaban in nonvalvular AF. After administration
of rivaroxaban, PMP levels were increased (median, [IQR] 35.7 [28.8-47.3] vs.
48.4 [30.9-82.8] cells/µL; P = 0.012), along with an increase
in EMP levels (14.6 [10.0-18.6] vs. 18.3 [12.9-37.1] cells/µL,
P < 0.001). In the multivariable regression analysis,
the independent predictor of post-dose change in PMPs was statin therapy (HR
−0.43; 95% CI −0.75,−0.10, P = 0.011). The post-dose change in
EMPs was also predicted by statin therapy (HR −0.34; 95% CI −0.69, −0.01,
P = 0.046). This study showed an increase in both EMPs and
PMPs at the peak plasma concentration of rivaroxaban. Statins have promising
potential in the prevention of rivaroxaban-related PMP and EMP release. The
pro-thrombotic role of PMPs and EMPs during rivaroxaban therapy requires further
study.
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