Study On Anti-coagulation Monitoring Index Of Rivaroxaban In Non-valvular Atrial Fibrillation

Objective:To find suitable indicators for monitoring the anticoagulation intensity of rivaroxaban by investigating the changes of laboratory coagulation parameters after taking rivaroxaban in patients with non-valvular atrial fibrillation(NVAF).Methods:60 patients with NVAF admitted to the Shanxi Dayi Hospital affliated to Shanxi Medical University from October 2017 to November 2017 were selected,including 35 males and 25 females.Depending on the risk of bleeding,renal function and general condition,cardiovascular physicians asked patients to take rivaroxaban 10 mg,15 mg or20 mg once daily.Observe the changes of clinical symptoms and signs after taking the drug,and collect the coagulation indexes at 3,6,9 and 12 months after taking the drug,including prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),international normalized ratio(INR),prothrombin activity(PTA),fibrinogen(FIB),antiprothrombin III activity(AT3)and D-dimer.Results:There were no significant differences in coagulation parameters between the 3,6,9and 12 months after taking the drug(P>0.05).When bleeding,the differences of PT and APTT between the patients and the normal population was statistically significant[PT(18.91±3.94)s vs.(11.57±0.69)s,(P<0.05);APTT(35.21±4.31)s vs.(29.69±2.48)s,(P<0.05)],but there was no significant difference of TT[TT(15.38±2.26)s vs.(14.89±1.11)s,(P>0.05)].In the ROC curve,PT had the highest predictive power for bleeding,and the area under the curve was 0.90(P<0.05).APTT and TT did not predict bleeding.The area under the APTT curve was 0.61(P>0.05),and the area under the TT curve was 0.44(P>0.05).Conclusion:When NVAF patients take rivaroxaban,PT is recommended to monitor anticoagulation intensity.After taking the rivaroxaban,the PT is preferably controlled within 1.5 times of the upper limit of the normal range.