Anticoagulant based on drug concentration by using mass spectrometry
| Project/Area Number |
17K09541
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Cardiovascular medicine
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| Research Institution | National Cardiovascular Center Research Institute |
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Principal Investigator |
Miyamoto Koji 国立研究開発法人国立循環器病研究センター, 病院, 医長 (50726429)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Keywords | atrial fibrillation / anticoagulant / 心房細動 / 抗凝固療法 / 血中濃度 / 薬物血中濃度 |
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| Outline of Final Research Achievements |
We have evaluated the impact of the drug concentration of DOACs (direct oral anticoagulants) on the bleeding complications in patients who administered DOACs for atrial fibrillation (AF).
1. The measurement of drug concentration of DOACs is useful for preventing bleeding complications from catheter ablation of AF; Lower drug concentration of DOACs increased the dose of heparin during catheter ablation procedure, which increased the bleeding complications. 2. Proton pump inhibitors (PPI) seem to affect the drug concentration/dose ration (C/D ratio) of DOACs; PPI decreased the C/D ration of Dabigatran, on the other hand, the PPI increased the C/D ratio of Apixaban. 3. Regarding the dose of DOACs, reduced dose may decrease the concentration of DOACs, leading to increase the risk of thromboembolism.
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| Academic Significance and Societal Importance of the Research Achievements |
心房細動による脳梗塞予防として直接経口抗凝固薬が投与されるが、直接経口抗凝固薬の投与によって、出血性合併症を生じることがある。直接経口抗凝固薬の薬剤血中濃度と出血性合併症の関連は不明であった。本研究により、直接経口抗凝固薬の薬剤血中濃度（測定）が、1. カテーテルアブレーションの際の出血性合併症の予防管理に有用であること、2. 他剤の影響を受けること、3. 直接経口抗凝固薬の減量により影響を受けること、が示された。
以上のことから、直接経口抗凝固薬の薬剤血中濃度測定を行うことが、直接経口抗凝固薬による出血性合併症を減らすために有効であると考えられる。
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Report
(4 results)
Research Products
(4 results)
