Edoxaban effectively keeps D-dimer low in patients with NVAF, AHF

Patients with nonvalvular atrial fibrillation (NVAF) and acute heart failure (AHF) see elevated levels of D-dimer, for which edoxaban may be effective, reports a recent study.

The study included 13 hospitalized patients (mean age 68 years, 92.3 percent men) who were initiated on edoxaban due to NVAF according to label instructions. The primary outcome was the change in D-dimer levels, as measured using a latex immunoturbidimetric assay, 7 days after admission.

D-dimer levels were generally high across all patients, with an average concentration of 2.12 µg/mL, with 76.9 percent of patients showing levels above the reference value of 1.0 µg/mL. Notably, three patients had D-dimer levels above 3.5 µg/mL on day 1, which persisted throughout the study.

Over a mean observation period 13 days, D-dimer levels showed a steady decline such that the mean concentration at the time of final blood sampling was 1.12 µg/mL, with only six patients (46.2 percent) exceeding the reference value.

In comparison, a parallel group of 13 patients (mean age 75 years, 46.2 percent men), who had already been receiving edoxaban before hospitalization, showed lower D-dimer levels starting from day 1, with a mean of 0.93 µg/mL; only three patients (23.1 percent) exceeded the reference. D-dimer levels remained low or decreased further during the subsequent follow-up period.

“Overall, our data confirm that edoxaban administration is useful for decreasing and keeping D-dimer levels to the reference range in patients with NVAF and AHF,” the researchers said. “Thus, we anticipate that a therapeutic anticoagulant state can be achieved with edoxaban even in patients at high risk of developing ischaemic stroke, and we expect edoxaban to be clinically useful in preventing cardiogenic cerebral infarction in this population.”