| Title |
Drug interaction as a predictor of direct oral anticoagulant drug levels in atrial fibrillation patients
|
|---|---|
| Published in |
Journal of Thrombosis and Thrombolysis, September 2018
|
| DOI | 10.1007/s11239-018-1738-7 |
| Pubmed ID | |
| Authors |
Bruria Hirsh Raccah, Amihai Rottenstreich, Netanel Zacks, Mordechai Muszkat, Ilan Matok, Amichai Perlman, Yosef Kalish |
| Abstract |
Data are limited on the effects of drug interactions on direct-acting oral anticoagulant (DOAC) levels. We evaluated the effects of the use of interacting drugs on DOAC levels in patients with atrial fibrillation (AF). We reviewed data of AF patients tested for DOAC levels in 2013-2017. The primary outcomes were drug levels exceeding the expected steady-state range, and in the highest quartile. A multivariate analysis was performed to evaluate the correlation of treatment by the use of interacting drugs, CYP3A4 and P-glycoprotein (P-gp) inhibitors, with the primary outcomes. Overall, 147 patients underwent DOAC level measurement [dabigatran (n = 31), rivaroxaban (n = 29), apixaban (n = 87)]. Thirty-three (22.4%) had drug levels exceeding the expected range. Seventy-nine (53.7%) patients were treated with at least one interacting drug. In multivariate analysis, the concomitant use of interacting drugs was an independent predictor for drug levels exceeding the expected range (OR 3.3, 95% CI 1.20-9.05). The defined daily dose of the interacting drug correlated positively with DOAC levels (r = 0.29, P = 0.001). Co-treatment with interacting drugs was associated with extremely high levels of dabigatran, (OR 16.6, 95% CI 1.29-215.18) but not of the other DOAC examined. Concomitant use of interacting drugs is associated with high DOAC levels in patients with AF. Further investigation is warranted to establish the differences between specific DOAC, evaluate the effect on patient outcomes, and characterize the role of DOAC monitoring in this setting. |
X Demographics
The data shown below were collected from the profiles of 18 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 4 | 22% |
| Canada | 4 | 22% |
| United States | 3 | 17% |
| Australia | 1 | 6% |
| Malaysia | 1 | 6% |
| Unknown | 5 | 28% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 10 | 56% |
| Scientists | 5 | 28% |
| Practitioners (doctors, other healthcare professionals) | 3 | 17% |
Mendeley readers
The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 27 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 4 | 15% |
| Student > Ph. D. Student | 3 | 11% |
| Student > Master | 3 | 11% |
| Student > Bachelor | 2 | 7% |
| Other | 2 | 7% |
| Other | 6 | 22% |
| Unknown | 7 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 8 | 30% |
| Pharmacology, Toxicology and Pharmaceutical Science | 7 | 26% |
| Materials Science | 1 | 4% |
| Psychology | 1 | 4% |
| Unknown | 10 | 37% |
Attention Score in Context
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 December 2018.
All research outputs
#3,936,055
of 24,344,498 outputs
Outputs from Journal of Thrombosis and Thrombolysis
#132
of 1,038 outputs
Outputs of similar age
#73,096
of 339,915 outputs
Outputs of similar age from Journal of Thrombosis and Thrombolysis
#6
of 20 outputs
Altmetric has tracked 24,344,498 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,038 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 339,915 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 78% of its contemporaries.
We're also able to compare this research output to 20 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 75% of its contemporaries.