Journal of Thrombosis and Thrombolysis

, Volume 47, Issue 1, pp 140–145 | Cite as

Does proton pump inhibition change the on-treatment anti-Xa activity in xabans-treated patients with atrial fibrillation? A pilot study

  • Tomáš Bolek
  • Matej SamošEmail author
  • Ingrid Škorňová
  • Lucia Stančiaková
  • Ján Staško
  • Barbora Korpallová
  • Peter Galajda
  • Peter Kubisz
  • Marián Mokáň


Proton pump inhibition (PPI) reduces gastrointestinal bleeding on direct oral anticoagulants. However, PPI may affect dabigatran on-treatment levels; and there is no information regarding the effect of PPI on xabans on-treatment activity. Thus, the aim of this study was to determine the impact of PPI on therapeutic anti-Xa activity in rivaroxaban- and apixaban-treated patients with atrial fibrillation (AF). This single-centre pilot prospective study enrolled 77 consecutive xabans-treated patients (42 rivaroxaban-treated and 35 apixaban-treated patients) with AF. PPI was administrated in 44 patients. Trough and peak anti-Xa activity was assessed with factor Xa-calibrated anti-Xa chromogenic analysis. There were no significant differences in trough anti-Xa activity comparing PPI-treated patients and patients without PPI (80.5 ± 66.5 ng/mL in PPI group vs. 71.6 ± 64.1 ng/mL in non-PPI group, p = 0.57, Table 2). Similarly, there were no significant differences in peak anti-Xa activity between compared groups (175.2 ± 102.5 ng/mL in PPI group vs. 202.9 ± 84.1 ng/mL in non-PPI group, p = 0.21). This pilot study did not reveal significant changes in xabans on-treatment anti-Xa activity according the PPI status.


Proton pump inhibitors Xabans Rivaroxaban Apixaban Anti-Xa activity Atrial fibrillation 



This study was supported by Research Project of Comenius University in Bratislava UK/386/2018 and by Research Project APVV (Slovak Research and Development Agency) 16-0020.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest that might be relevant to the contents of this manuscript.

Ethical approval

This research was done according to ethical standards and was approved by the Local Ethical Committee (Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava).

Informed consent

The patients agreed to participate in the research and signed informed consent for study participation.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Internal Medicine I, Jessenius Faculty of Medicine in MartinComenius University in BratislavaMartinSlovakia
  2. 2.National Centre of Hemostasis and Thrombosis, Department of Hematology and Blood Transfusion, Jessenius Faculty of Medicine in MartinComenius University in BratislavaMartinSlovakia

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