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Journal of the American College of Cardiology
Article . 2019 . Peer-reviewed
License: CC BY NC ND
Data sources: Crossref
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Journal of the American College of Cardiology
Article
License: CC BY NC ND
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Dabigatran Reversal With Idarucizumab in Patients With Renal Impairment

Authors: Charles V. Pollack; Joanne van Ryn; Stephan Glund; Amelie Elsaesser; Paul A. Reilly; Jeffrey I. Weitz; John W. Eikelboom; +2 Authors

Dabigatran Reversal With Idarucizumab in Patients With Renal Impairment

Abstract

Dabigatran and idarucizumab, its reversal agent, are renally cleared.The purpose of this study was to determine the extent of reversal and outcomes according to baseline renal function in dabigatran-treated nondialysis patients receiving idarucizumab.In 503 patients in RE-VERSE AD (Reversal of Effects of Idarucizumab in Patients on Active Dabigatran), the extent of dabigatran reversal and clinical outcomes were compared according to baseline renal function (creatinine clearance: normal ≥80, mild 50 to 20 ng/ml compared with 8.3% of patients with normal renal function at baseline. Time to cessation of bleeding and the proportion with normal hemostasis with procedures were similar regardless of renal function, but patients with severe renal impairment had higher 30- and 90-day mortality rates.Idarucizumab completely reverses dabigatran in >98% of patients regardless of renal function. Although re-elevation of dabigatran levels within 12 to 24 h is more common with renal impairment, the time to bleeding cessation and the extent of hemostasis during procedures are similar. (Reversal of Dabigatran Anticoagulant Effect With Idarucizumab; NCT02104947).

Keywords

Aged, 80 and over, Male, Hemorrhage, Middle Aged, Antibodies, Monoclonal, Humanized, Antithrombins, Dabigatran, Cohort Studies, Treatment Outcome, Humans, Female, Prospective Studies, Renal Insufficiency, Blood Coagulation, Aged

  • BIP!
    Impact byBIP!
    citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    28
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
28
Top 10%
Top 10%
Top 10%
hybrid