Comparative studies on the effect of newer oral anticoagulants on platelet aggregation. Pharmacological and developmental implications

Abstract

The newer oral anticoagulants include Dabigatran, Apixiban and Rivaroxiban. These drugs are developed for the DVT and stroke prevention in atrial fibrillation. These drugs are useful as alternate anticoagulants for heparin compromised patients. The purpose of this investigation was to study their effects on agonist induced platelet aggregation. Such agonist as epinephrine, collagen, arachidonic acis, ADP and thrombin were used in whole blood (multiplate) and citrated PRP systems (PAP8). In addition the interaction of these agents with heparin induced thrombocytopenia associated antibodies were also studied. Each of these agents were supplemented in citrated whole blood at a concentration range of 0–10ug/ml, agonists were added and the aggregation profile was recorded in both the whole blood and PRP. Serum from patients with HIT syndrome was also used to compare the aggregation profile of these agents with heparin. None of these newer oral anticoagulants produced any alterations of the aggregation profile in both the whole blood and platelet rich plasma (20–30;p=<0.05) with all of the agonists except thrombin. Dabigatran supplemented systems showed inhibition wheras Apixiban and Rvaroxiban did not produce inhibition of thrombin aggregation. These results suggest that newer oral anticoagulants do not impair the agonist induced platelet aggregation and will be useful in heparin compromised patients.