Effect of apixaban on endogenous fibrinolysis in atrial fibrilation
Research type
Research Study
Full title
ASSESSING THE EFFECT OF APIXABAN ON ENDOGENOUS FIBRINOLYSIS IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION
IRAS ID
222252
Contact name
Diana Gorog
Contact email
Sponsor organisation
East and North Hertfordshire NHS Trust
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Patients with an irregular heart rhythm called atrial fibrillation (AF) have an increased risk of forming blood clots inside the heart, that can then fragment and break off, travelling through the circulation to the brain, where it can cause blockage of the small blood vessels resulting in a stroke. Most patients with AF are prescribed blood thinning medications in an attempt to prevent such clot formation. The body has the ability through enzymes circulating in blood, to dissolve a clot once formed, such that even if a clot is formed, it is rapidly dissolved and no lasting damage is sustained. This is known as endogenous fibrinolysis. If this defence system is faulty or suboptimal, there is an increased risk of clot formation, resulting in stroke or heart attack Currently, there are no available tablets to favourably modify this defence system of endogenous fibrinolysis. We will assess how this defence system functions in patients with AF who are on different blood thinners. Then we will also assess a group of patients before and during treatment with a relatively new blood thinner called apixaban, to assess the effect of this on the stickiness of blood and the ability of the blood to dissolve clots (endogenous fibrinolysis). All the blood thinners will be prescribed for clinical indications, not as part of the research. The research aspect of the study is that we will perform a blood test to assess endogenous fibrinolysis.
Understanding the effect of apixaban on endogenous fibrinolysis raises the possibility that apixaban, rather than other blood thinners, may be of particular use in patients with impaired fibrinolysis who are at particularly high risk of clots due to inefficient endogenous fibrinolysis.REC name
London - Fulham Research Ethics Committee
REC reference
17/LO/0305
Date of REC Opinion
2 Mar 2017
REC opinion
Favourable Opinion