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Age-related variation in coagulation factors in non-valvular atrial fibrillation patients receiving direct oral anticoagulants

  • Osamu Kumano,
  • Shinya Suzuki,
  • Masako Yamazaki,
  • Yoshimori An,
  • Masahiro Yasaka,
  • Masahiro Ieko,
  • Mayumi Sasaki,
  • Kazumi Matsuda,
  • Kazuo Kitagawa,
  • Tsuyoshi Shiga,
  • Hitomi Miura,
  • Takako Tamura,
  • Maki Kondo,
  • Masaharu Akao,
  • Chika Kamata,
  • Yoshinobu Masuda,
  • Tomoko Mitsuhashi,
  • Masanori Tomoda,
  • Ryuuta Tomoyose,
  • Akihiko Nishiura,
  • Mihoko Maeda,
  • Kazumasa Ohmura,
  • Sumiyoshi Naito,
  • Mayumi Shitamichi,
  • Hiroko Juraku,
  • Daiki Hatanaka,
  • Keisuke Kitano,
  • Nobuo Arai,
  • Hidenari Takaoka,
  • Hiroshi Kanda

摘要

Age is a significant risk factor for ischemic stroke. However, the influence of aging on coagulation parameters in non-valvular atrial fibrillation (NVAF) patients treated with direct oral anticoagulants (DOACs) remains unclear. A total of 775 samples were collected from 224 NVAF patients receiving apixaban, edoxaban or rivaroxaban. The samples were categorized into three age groups: (i) ≤ 64 years, (ii) 65–74 years, and (iii) ≥ 75 years (apixaban: N = 48, 108, 119; edoxaban: N = 63, 68, 126; rivaroxaban: N = 115, 90, 38, respectively). Coagulation parameters including fibrinogen (Fbg), factor II, factor V, factor VII, factor X, and D-dimer, were compared between the three age groups for each drug. The slopes in the correlation between drug concentrations and modified diluted prothrombin time (mdPT) were also assessed. Fbg and factor V increased with age, while factor II and factor X decreased. Factor VII and D-dimer showed no significant differences across age categories. The slope in response to drug concentrations was similar between the age groups. In NVAF patients treated with apixaban, edoxaban and rivaroxaban, some coagulation parameters exhibited age-related variation. However, the response of mdPT to drug concentration was consistent across age categories.