Abstract:
Introduction: Atrial fibrillation (AF) is a common disease that increases mortality and morbidity. New generation oral anticoagulants (NOACs) are agents that reduce ischemic events in patients with AF. In this study, we aim to compare biochemical and clinical parameters and examine the risk factors for thrombotic complications (such as stroke, myocardial infarction, systemic embolization) in patients using NOACs (dabigatran and rivaroxaban).
Methods: This study was designed as a retrospective, method development study. The study included 205 patients who were admitted to Emergency Service, Adiyaman University Training and Research Hospital, from January 2013 to December 2014. The patients were divided into two groups as rivaroxaban users and dabigatran users. The differences of laboratory parameters of patients before drug intake and during their emergency department visits were analyzed. [Delta white blood cells, Delta hemoglobin, Delta hematocrit, Delta platelet, Delta platecrit, Delta platelet distribution width, mean platelet volume (Delta MPV)].
Results: There were no major differences between two groups in terms of CHA(2)DS(2)-VASc scores, complications and duration of drug intake. There was statistically significant decrease with regard to MPV (p<0.001), in both of the groups with the usage of NOACs. The optimal threshold point of Delta MPV in the prediction of the thrombotic complications was <= 0.7 fL, with 91.7% sensitivity and 62.2% specificity [area under the curve: 0.805, 95% confidence interval: 0.744-0.857, p<0.001).
Conclusion: As a result, the detection of high CHA(2)DS(2)-VASc score for the patients with AF using NOACs and visiting emergency department and less volume decline in previous MPV value are simple parameters to be used for predicting thrombotic cases and will be clinically useful.
