Title :

Rivaroxaban plasma levels in acute ischemic stroke and intracerebral hemorrhage

Author(s) :

Seiffge, David J. [Auteur]
Kagi, Georg [Auteur]
Michel, Patrik [Auteur]
Fischer, Urs [Auteur]
Bejot, Yannick [Auteur]
Wegener, Susanne [Auteur]
Zedde, Marialuisa [Auteur]
Turc, Guillaume [Auteur]
Cordonnier, Charlotte [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Sandor, Peter S. [Auteur]
Rodier, Gilles [Auteur]
Zini, Andrea [Auteur]
Cappellari, Manuel [Auteur]
Schadelin, Sabine [Auteur]
Polymeris, Alexandros A. [Auteur]
Werring, David J. [Auteur]
Thilemann, Sebastian [Auteur]
Maestrini, Ilaria [Auteur]
Berge, Eivind [Auteur]
Traenka, Christopher [Auteur]
Vehoff, Jochen [Auteur]
De Marchis, Gian Marco [Auteur]
Kapauer, Monika [Auteur]
Peters, Nils [Auteur]
Sirimarco, Gaia [Auteur]
Bonati, Leo H. [Auteur]
Arnold, Marcel [Auteur]
Lyrer, Philippe A. [Auteur]
De Maistre, Emmanuel [Auteur]
Luft, Andreas [Auteur]
Tsakiris, Dimtrios A. [Auteur]
Engelter, Stefan T. [Auteur]

Journal title :

Annals of neurology

Abbreviated title :

Ann. Neurol.

Publication date :

2018-02-02

ISSN :

1531-8249

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Information about rivaroxaban plasma level (RivLev) may guide treatment decisions in patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) taking rivaroxaban. In a multicenter registry-based study ...
Show more >Information about rivaroxaban plasma level (RivLev) may guide treatment decisions in patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) taking rivaroxaban. In a multicenter registry-based study (Novel Oral Anticoagulants in Stroke Patients collaboration; ClinicalTrials.gov: NCT02353585) of patients with stroke while taking rivaroxaban, we compared RivLev in patients with AIS and ICH. We determined how many AIS patients had RivLev ≤ 100ng/ml, indicating possible eligibility for thrombolysis, and how many ICH patients had RivLev ≥ 75ng/ml, making them possibly eligible for the use of specific reversal agents. We explored factors associated with RivLev (Spearman correlation, regression models) and studied the sensitivity and specificity of international normalized ratio (INR) thresholds to substitute RivLev using cross tables and receiver operating characteristic curves. Among 241 patients (median age = 80 years, interquartile range [IQR] = 73-84; median time from onset to admission = 2 hours, IQR = 1-4.5 hours; median RivLev = 89ng/ml, IQR = 31-194), 190 had AIS and 51 had ICH. RivLev was similar in AIS patients (82ng/ml, IQR = 30-202) and ICH patients (102ng/ml, IQR = 51-165; p = 0.24). Trough RivLev(≤137ng/ml) RivLev did not differ between patients with AIS and ICH. Half of the patients with AIS under rivaroxaban had a RivLev low enough to consider thrombolysis. In ICH patients, two-thirds had a RivLev high enough to meet the eligibility for the use of a specific reversal agent. INR thresholds perform poorly to inform treatment decisions in individual patients. Ann Neurol 2018;83:451-459.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
CNRS
Inserm
Université de Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172

Research team(s) :

Troubles cognitifs dégénératifs et vasculaires

Submission date :

2019-11-27T14:32:08Z