Practical use of idarucizumab
The number of patients with indications for direct oral anticoagulants (DOACs) to prevent thrombotic events is steadily growing. However, in 1,1-2,2% of cases, ischemic strokes occur within DOAC therapy. In this case, DOAC use is a limitation for systemic thrombolysis, except for available reversal...
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| Format: | Article |
| Language: | Russian |
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«SILICEA-POLIGRAF» LLC
2023-11-01
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| Series: | Кардиоваскулярная терапия и профилактика |
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| Online Access: | https://cardiovascular.elpub.ru/jour/article/view/3774 |
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| author | G. R. Ramazanov E. A. Kovaleva E. V. Klychnikova S. S. Petrikov N. A. Shamalov I. S. Aliev E. V. Shevchenko |
| author_facet | G. R. Ramazanov E. A. Kovaleva E. V. Klychnikova S. S. Petrikov N. A. Shamalov I. S. Aliev E. V. Shevchenko |
| author_sort | G. R. Ramazanov |
| collection | DOAJ |
| description | The number of patients with indications for direct oral anticoagulants (DOACs) to prevent thrombotic events is steadily growing. However, in 1,1-2,2% of cases, ischemic strokes occur within DOAC therapy. In this case, DOAC use is a limitation for systemic thrombolysis, except for available reversal of anticoagulation. In order to immediately inactivate the anticoagulant effect of dabigatran etexilate (DE), reversal agent idarucizumab is used.Aim. To evaluate the effectiveness and safety of idarucizumab in clinical practice.Material and methods. The study included 9 patients taking DE who developed urgent conditions that required emergency reversal of anticoagulation with idarucizumab.Results. Normalization of thrombin time (TT) was achieved in 7 (77,8%) patients immediately after idarucizumab administration. In two patients, 10 minutes after the administration of a specific DE reversal agent, TT decreased, but did not reach reference values (case 1: TT decreased from 181 to 23,3 seconds; case 2: TT decreased from 181 to 18,3 seconds); 30 minutes after the idarucizumab administration, TT normalization was achieved.Conclusion. Nobody developed clinically significant arterial and/or venous thrombotic events during the entire period of hospitalization. Rapid reversal of anticoagulation with idarucizumab allows immediate systemic thrombolytic therapy or surgery in patients taking DE without the increase of bleeding or thrombosis risk and the need for control coagulation analysis. |
| format | Article |
| id | doaj-art-32bb45e4dec44c9c82eb0fb1f1feea28 |
| institution | Matheson Library |
| issn | 1728-8800 2619-0125 |
| language | Russian |
| publishDate | 2023-11-01 |
| publisher | «SILICEA-POLIGRAF» LLC |
| record_format | Article |
| series | Кардиоваскулярная терапия и профилактика |
| spelling | doaj-art-32bb45e4dec44c9c82eb0fb1f1feea282025-08-04T12:50:30Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252023-11-01221010.15829/1728-8800-2023-37742817Practical use of idarucizumabG. R. Ramazanov0E. A. Kovaleva1E. V. Klychnikova2S. S. Petrikov3N. A. Shamalov4I. S. Aliev5E. V. Shevchenko6Sklifosovsky Research Institute for Emergency MedicineSklifosovsky Research Institute for Emergency MedicineSklifosovsky Research Institute for Emergency MedicineSklifosovsky Research Institute for Emergency MedicineFederal Center of Brain ResearchSklifosovsky Research Institute for Emergency MedicineSklifosovsky Research Institute for Emergency MedicineThe number of patients with indications for direct oral anticoagulants (DOACs) to prevent thrombotic events is steadily growing. However, in 1,1-2,2% of cases, ischemic strokes occur within DOAC therapy. In this case, DOAC use is a limitation for systemic thrombolysis, except for available reversal of anticoagulation. In order to immediately inactivate the anticoagulant effect of dabigatran etexilate (DE), reversal agent idarucizumab is used.Aim. To evaluate the effectiveness and safety of idarucizumab in clinical practice.Material and methods. The study included 9 patients taking DE who developed urgent conditions that required emergency reversal of anticoagulation with idarucizumab.Results. Normalization of thrombin time (TT) was achieved in 7 (77,8%) patients immediately after idarucizumab administration. In two patients, 10 minutes after the administration of a specific DE reversal agent, TT decreased, but did not reach reference values (case 1: TT decreased from 181 to 23,3 seconds; case 2: TT decreased from 181 to 18,3 seconds); 30 minutes after the idarucizumab administration, TT normalization was achieved.Conclusion. Nobody developed clinically significant arterial and/or venous thrombotic events during the entire period of hospitalization. Rapid reversal of anticoagulation with idarucizumab allows immediate systemic thrombolytic therapy or surgery in patients taking DE without the increase of bleeding or thrombosis risk and the need for control coagulation analysis.https://cardiovascular.elpub.ru/jour/article/view/3774idarucizumabdabigatran etexilatecerebrovascular accidentthrombin timesystemic thrombolytic therapy |
| spellingShingle | G. R. Ramazanov E. A. Kovaleva E. V. Klychnikova S. S. Petrikov N. A. Shamalov I. S. Aliev E. V. Shevchenko Practical use of idarucizumab Кардиоваскулярная терапия и профилактика idarucizumab dabigatran etexilate cerebrovascular accident thrombin time systemic thrombolytic therapy |
| title | Practical use of idarucizumab |
| title_full | Practical use of idarucizumab |
| title_fullStr | Practical use of idarucizumab |
| title_full_unstemmed | Practical use of idarucizumab |
| title_short | Practical use of idarucizumab |
| title_sort | practical use of idarucizumab |
| topic | idarucizumab dabigatran etexilate cerebrovascular accident thrombin time systemic thrombolytic therapy |
| url | https://cardiovascular.elpub.ru/jour/article/view/3774 |
| work_keys_str_mv | AT grramazanov practicaluseofidarucizumab AT eakovaleva practicaluseofidarucizumab AT evklychnikova practicaluseofidarucizumab AT sspetrikov practicaluseofidarucizumab AT nashamalov practicaluseofidarucizumab AT isaliev practicaluseofidarucizumab AT evshevchenko practicaluseofidarucizumab |