The Effect of Contrast Agents on the Anticoagulant Properties of Oral
Factor Xa Inhibitors
Abstract
Objective:The aim of this study is to evaluate the effect of iohexol as
a contrast agent on the anticoagulant activity of oral factor Xa
inhibitors. Methods:The study included 65 people who underwent contrast
computerized tomography (CT). Patients in group 1 were using rivaroxaban
(20 patients), patients in group 2 were using apixaban (20 patients),
patients in group 3 were using edoxaban (20 patients), and group 4 was
the control group (5 volunteers). Iohexol (60ml) was used as a contrast
agent. Two tubes were used to collect 2 ml of blood from the patients at
4 hours after the drug dose (rivaroxaban, apixaban, or edoxaban) and 1
hour after the contrast CT (CT was performed 3 hours after the drug was
taken). In the control group, at any time and 1 hour after contrast CT,
2 tubes of 2 ml of blood were collected. The anticoagulant properties of
rivaroxaban, apixaban, and edoxaban were evaluated using anti-factor Xa
levels. Results:The anti-factor Xa level was increased after using the
contrast agent in the rivaroxaban group (0.66±0.32U/ml vs.
0.67±0.32U/ml; p=0.01) and the edoxaban group (0.74±0.35 U/ml vs.
0.76±0.36 U/ml; p=0.006). However, there was no significant difference
in the apixaban group (0.66±0.33U/ml vs. 0.66±0.32U/ml; p=0.21) and
control group (0.02±0.01U/ml vs. 0.03±0.01U/ml; p=0.33). Conclusion:The
anticoagulant properties of rivaroxaban and edoxaban tended to increase
significantly, but there was no statistically significant difference in
the anticoagulant properties of apixaban with contrast agent. The
increasing is too small so that these laboratory results need to
validate with larger clinical trials(NCT04611386).