Assessment of the efficacy of a peroral anticoagulant after surgical resection of gastric cancer
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Patients suffering from gastric cancer have a high risk of postoperative thrombotic complications and often use anticoagulants. Direct oral anticoagulants absorb in the proximal region of the digestive tract. Consequently, a reduction in anticoagulating activity is possible. In the present research given is an evaluation of the anti-Xa activity upon administration of Rivaroxaban at a fixed dose of 20 mg once daily in oncological patients after gastrectomy or cases of extensive resection of the stomach.
Materials and methods
The study cohort covered 20 patients after surgical treatment of gastric cancer having normal renal/hepatic function. The patients received Rivaroxaban at a fixed dose of 20 mg once daily to prevent venous thromboembolic complications.
When evaluating absorption and bioavailability of 20 mg of Rivaroxaban sufficient anti-Xa blood plasma activity (1.37±0.16 UI/ml) was recorded. However, in 5 patients the absorption of a therapeutic agent was not-critical, their average anti-Xa activity being 0.32 ± 0.14 UI/ml.
Absorption of peroral anticoagulants in most patients who have experienced extensive stomach resections, is satisfactory. However, the level of anticoagulant activity showed significant changeability, as in a quarter of patients malabsorption of rivaroxaban was observed. Thus, when prescribing anticoagulant tablets to this category of patients it is necessary to control the absorption of medical drugs.
Oksana V. Katelnitskaya, Oleg I. Kit, Igor I. Katelnitsky, Maksim N. Duritsky, Nailya K. Guskova, Petr N. Gabrichidze, Viktoria R. Zakharchenko, Aleksandr V. Snezhko, Yuriy А. Przhedetskiy, Sergey I. Poluektov, Alla V. Pustovalova. Assessment of the efficacy of a peroral anticoagulant after surgical resection of gastric cancer. Cardiometry; Issue 13; November 2018; p.54-57 ; DOI: 10.12710/cardiometry.2018.13.5457; Available from: http://www.cardiometry.net/ issues/no13-november-2018/surgical-resection-of-gastric-cancer