Bleeding prediction by rotational thromboelastometry in chronic hemodialysis patients with non-valvular atrial fibrillation on apixaban

doi:10.4330/wjc.v17.i12.112046

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World Journal of Cardiology

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1949-8462

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Cardiol. Dec 26, 2025; 17(12): 112046
Published online Dec 26, 2025. doi: 10.4330/wjc.v17.i12.112046

Table 2 Coagulation parameters and apixaban levels, median (interquartile range)

Conventional coagulation tests (pre/post apixaban)	All patients (N = 19)	No Bleeding (n = 13)	Bleeding (n = 6)	P value
Prothrombin time-pre (second)	11.7 (11.3-12.8)	11.4 (11.1-12.1)	12.7 (11.7-13.8)	0.143
aPTT-pre (second)	34 (31-38)	34 (28-39)	32 (35-37)	0.597
Fibrinogen-pre (mg/dL)	440 (388-512)	440 (383-503)	467 (415-516)	0.394
D-dimers-pre (ng/mL)	633 (355-1423)	416 (307-1496)	713 (618-1504)	0.765
Prothrombin time-post (second)	12 (12-13)	11.5 (12-13)	13 (11.5-14)	0.636
aPTT-post (second)	34 (28-38)	34 (28-39)	35 (30-39)	0.535
Fibrinogen-post(mg/dL)	443 (359-528)	440 (355-518)	489 (340-536)	0.442
D-dimers-post (ng/mL)	585 (375-1418)	491 (217-1494)	699 (576-1404)	0.890
RΟΤΕΜ (pre/post apixaban)
Clotting time-pre (second)	83 (71-95)	85 (71-93)	80 (68-113)	0.372
Clot formation time-pre (second)	57 (51-68)	57 (53-66)	59 (47-82)	0.750
An angle-pre (rad)	78 (75-79)	79 (77-80)	78 (74-81)	0.992
Max clot firmness-pre (mm)	71 (66-73)	69 (66-73)	72 (65-74)	0.693
Maximum clot lysis-pre (%)	7 (6-8)	6 (4-7)	6 (5-7)	0.992
Li60-pre (%)	96 (94-97)	95 (94-97)	97 (93-98)	0.904
Clotting time-post (second)	102 (81-116)	87 (77-107)	118 (100-144)	0.008^a
Clot formation time-post (second)	66 (52-76)	66 (50-76)	68 (54-77)	0.692
An angle-post (rad)	77 (75-77)	77 (75-80)	77 (76-79)	0.961
Max clot firmness-post (mm)	69 (66-73)	69 (67-73)	71 (65-75)	0.865
Maximum clot lysis-post (%)	6 (4-7)	7 (6-10)	7 (5-10)	0.975
Li60-post (%)	95 (93-97)	94 (93-97)	96 (93-98)	0.719
CTdiff	8 (2-28)	7 (1.5-19)	38 (3-52)	0.013
PFA-200 (epinephrine)
Closure time (second)	135 (106-214)	123 (113-187)	172 (99-272)	0.425
Apixaban levels
Apixaban-trough (ng/mL)	93 (26-166)	93 (53-151)	65 (0-214)	0.918
Apixaban-peak (ng/mL)	163 (107-234)	183 (103-230)	139 (86-331)	0.841
Apxdiff	53 (27-107)	53 (35-100)	76 (21-137)	0.555

^aP < 0.01.

aPTT: Active partial thromboplastin time; ROTEM: Rotational thromboelastometry; Li60: Lysis index 60 minutes after clotting time; CTdiff: Difference between EXTEM clotting time after and prior administration of apixaban; PFA-200: Platelet Function Analyzer-200; Apxdiff: Difference between peak and trough levels of apixaban.

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Citation: Bacharaki D, Kyriakou E, Sardeli A, Nikolopoulos P, Triantaphyllis G, Drakou A, Makris F, Spanou E, Triantou E, Haviaras E, Fatourou A, Poulis A, Tsantes A, Kyriazis J, Lionaki S. Bleeding prediction by rotational thromboelastometry in chronic hemodialysis patients with non-valvular atrial fibrillation on apixaban. World J Cardiol 2025; 17(12): 112046
URL: https://www.wjgnet.com/1949-8462/full/v17/i12/112046.htm
DOI: https://dx.doi.org/10.4330/wjc.v17.i12.112046

Bacharaki D, Kyriakou E, Sardeli A, Nikolopoulos P, Triantaphyllis G, Drakou A, Makris F, Spanou E, Triantou E, Haviaras E, Fatourou A, Poulis A, Tsantes A, Kyriazis J, Lionaki S. Bleeding prediction by rotational thromboelastometry in chronic hemodialysis patients with non-valvular atrial fibrillation on apixaban. World J Cardiol 2025; 17(12): 112046 [PMID: 41479990 DOI: 10.4330/wjc.v17.i12.112046]

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