D-dimer levels in patients with nonvalvular atrial fibrillation and acute heart failure treated with edoxaban.

Abstract

BACKGROUND:

D-dimer levels can predict ischemic stroke in patients with acute heart failure (AHF). However, the effects of direct oral anticoagulants on D-dimer levels have not been investigated during admission for AHF in patients with atrial fibrillation (AF). This study examined D-dimer levels immediately after admission and following edoxaban initiation as a sub-analysis of a multi-center study that investigated the pharmacokinetics and pharmacodynamics of edoxaban in patients with nonvalvular AF (NVAF) and AHF.

METHODS:

Hospitalized patients with NVAF and AHF received edoxaban according to the label. The primary measure was the change in D-dimer levels on 7 consecutive days after admission for AHF. We also investigated differences according to prior edoxaban use (de novo at the time of admission or continuation).

RESULTS:

In 10/13 (76.9%) de novo patients, D-dimer levels exceeded the reference value (1.0 µg/mL) at admission (mean, 2.12 µg/mL) and subsequently decreased in 9 patients (at final blood sampling: mean, 1.12 µg/mL); 1 patient did not fall below the reference value due to stasis dermatitis. In the continuation group, most patients had D-dimer levels below the reference value from Day 1 (mean, 0.93 µg/mL), and levels remained stable or decreased (at final blood sampling: mean, 0.49 µg/mL). No events of stroke were observed.

CONCLUSIONS:

D-dimer levels may be elevated in patients with NVAF and AHF, particularly in those without prior anticoagulant treatment. Edoxaban may be effective for lowering and keeping D-dimer levels, a biomarker for predicting ischemic stroke, below the reference value in patients with NVAF and AHF.

• Authors: Keisuke Kida, Takeru Nabeta, Miwa Ishida, Takaaki Shiono, Norio Suzuki, Shunichi Doi, Maya Tsukahara, Yuki Ohta, Tetsuya Kimura, Yoshiyuki Morishima, Atsushi Takita, Naoki Matsumoto, Yoshihiro J Akashi, Junya Ako, Takayuki Inomata
• Journal: Journal of cardiology (J Cardiol) Vol. 79 Issue 6 Pg. 759-767 (06 2022) ISSN: 1876-4738 [Electronic] Netherlands
• PMID: 35148920 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022. Published by Elsevier Ltd.

Chemical References

• Anticoagulants
• Fibrin Fibrinogen Degradation Products
• Pyridines
• Thiazoles
• fibrin fragment D
• edoxaban

Topics

• Anticoagulants
• Atrial Fibrillation (complications, drug therapy)
• Fibrin Fibrinogen Degradation Products
• Heart Failure (drug therapy)
• Humans
• Ischemic Stroke
• Pyridines
• Stroke (etiology)
• Thiazoles