• Armando Tripodi, Lidia Padovan, Chantarangkul Veena, Erica Scalambrino, Sophie Testa, and Flora Peyvandi.
• Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, MiIano, ltaly; IRCCS Cà Granda Maggiore Hospital Foundation, Milano, Italy. Electronic address: armando.tripodi@unimi.it.
• Thromb. Res. 2015 Jun 1; 135 (6): 1186-90.

Background And ObjectivesApixaban is a direct oral anticoagulant (DOAC) targeting factor Xa and thus quenching thrombin generation and clot formation. However, little information is available on the influence that apixaban may have on the parameters of thrombin generation.MethodsAliquots of a pooled normal plasma have been added with increased concentrations of purified apixaban and were used to assess the degree of modification brought about by the drug on the basic tests of coagulation prothrombin and activated partial thromboplastin time (PT and APTT) and on thrombin generation parameters.ResultsThe study shows that while apixaban has little effect on PT or APTT it does affect all the parameters of thrombin generation, including the lag-time (which is increased), the endogenous thrombin potential (ETP) and thrombin-peak (both decreased although to a different extent), and the velocity index (decreased). Interestingly, the above effects were more pronounced when the measurements were recorded in the presence of thrombomodulin, thus making the ratio (with/without thrombomodulin) to decrease consistently as a function of the apixaban concentrations.ConclusionsThese findings support the antithrombotic properties of apixaban and can help to understand the mechanism(s) of action of this drug. Thrombin generation could be used as a convenient laboratory tool to assess the anticoagulant activity of other drugs and to make between-DOAC comparison.Copyright © 2015 Elsevier Ltd. All rights reserved.

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