{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T11:58:21Z","timestamp":1793361501806,"version":"4.5.0"},"reference-count":53,"publisher":"Georg Thieme Verlag KG","issue":"12","funder":[{"DOI":"10.13039\/501100000023","name":"Government of Canada","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000023","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"crossref","award":["Grant ID 313156"],"award-info":[{"award-number":["Grant ID 313156"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100032667","name":"CanVECTOR","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100032667","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Heart and Stroke Foundation of Canada","award":["G-14-0006136"],"award-info":[{"award-number":["G-14-0006136"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A direct oral anticoagulant (DOAC) concentration threshold above which an impact on surgical hemostasis starts to occur is unknown. Thrombin generation assays (TGAs) provide a measure of the coagulation phenotype. This study aimed to determine whether preoperative TGA parameters are associated with postoperative bleeding, and whether this is partly due to residual DOAC levels.<\/jats:p>\n                  <jats:p>We conducted a nested case\u2013control study using samples from apixaban\/rivaroxaban-treated patients with atrial fibrillation from the PAUSE (Perioperative Anticoagulation Use for Surgery Evaluation) perioperative study. Cases were participants with postoperative major or clinically relevant nonmajor bleeding; controls were participants without bleeding. DOAC levels were measured using a chromogenic anti-Xa assay (BIOPHEN DiXaI; rivaroxaban\/apixaban calibrators). TGA parameters were measured using calibrated automated thrombography.<\/jats:p>\n                  <jats:p>Generalized linear mixed models and causal mediation analyses were used to evaluate the relationship between DOAC levels, TGA parameters, and bleeding.<\/jats:p>\n                  <jats:p>Forty eight cases were matched to 474 controls. Residual DOAC levels were higher in cases than controls (p\u2009=\u20090.03) and each TGA parameter was correlated with residual DOAC levels (p&lt;0.05). A longer lag time (LT; odds ratio [OR]\u2009=\u20091.319 per minute [95% confidence interval [CI]: 1.077\u20131.617]) and time-to-peak (TTP; OR\u2009=\u20091.154 per minute [95% CI: 1.028\u20131.296]) were associated with an increased odds of bleeding; higher peak (OR\u2009=\u20090.994 per nM [95% CI: 0.989\u20130.998]) and mean velocity rate index (mVRI; OR\u2009=\u20090.986 per nM\/min [95% CI: 0.976\u20130.996]) were associated with a lower odds of bleeding. The effect of apixaban\/rivaroxaban levels on bleeding was mediated by altered TGA parameters (LT, TTP, peak, mVRI).<\/jats:p>\n                  <jats:p>These findings support a measurable effect from low residual DOAC levels on thrombin generation and suggest a causal contribution of both toward bleeding.<\/jats:p>","DOI":"10.1055\/a-2521-0923","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T19:28:01Z","timestamp":1737487681000},"page":"1226-1239","source":"Crossref","is-referenced-by-count":12,"title":["Influence of Direct Oral Anticoagulant Levels and Thrombin Generation on Postoperative Bleeding [SONAR]: A Nested Case\u2013Control Study"],"prefix":"10.1055","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2405-7912","authenticated-orcid":false,"given":"Joseph R.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada"},{"name":"Department of Computing and Software, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Gruss\u00e9","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Stago, Gennevilliers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Van Dreden","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Stago, Gennevilliers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"St John","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Nixon","sequence":"additional","affiliation":[{"name":"Michael G. DeGroote Centre for Transfusion Research, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3175-461X","authenticated-orcid":false,"given":"Alex C.","family":"Spyropoulos","sequence":"additional","affiliation":[{"name":"Department of Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell, Northwell Health at Lenox Hill Hospital, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8512-9043","authenticated-orcid":false,"given":"Sam","family":"Schulman","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Obstetrics and Gynecology and Perinatal Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerrold H.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, North Carolina, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Carrier","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Douketis","sequence":"additional","affiliation":[{"name":"Department of Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"e207","DOI":"10.1016\/j.chest.2022.07.025","article-title":"Perioperative management of antithrombotic therapy: an American College of Chest Physicians Clinical Practice Guideline","volume":"162","author":"J D Douketis","year":"2022","journal-title":"Chest"},{"issue":"11","key":"ref2","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1111\/jth.14598","article-title":"Scientific and Standardization Committee Communication: guidance document on the periprocedural management of patients on chronic oral anticoagulant therapy: recommendations for standardized reporting of procedural\/surgical bleed risk and patient-specific thromboembolic risk","volume":"17","author":"A C Spyropoulos","year":"2019","journal-title":"J Thromb Haemost"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"203","DOI":"10.2165\/00003088-200847030-00006","article-title":"Population pharmacokinetics and pharmacodynamics of rivaroxaban\u2013an oral, direct factor Xa inhibitor\u2013in patients undergoing major orthopaedic surgery","volume":"47","author":"W Mueck","year":"2008","journal-title":"Clin Pharmacokinet"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1182\/blood.V108.11.905.905","article-title":"The Effect of extreme age, and gender, on the pharmacology and tolerability of rivaroxaban - 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samples","volume":"28","author":"P C Austin","year":"2009","journal-title":"Stat Med"},{"key":"ref31","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"J Cohen","year":"1988","edition":"2nd ed."},{"issue":"02","key":"ref32","doi-asserted-by":"crossref","first-page":"e30385","DOI":"10.1371\/journal.pone.0030385","article-title":"Defining the boundaries of normal thrombin generation: investigations into hemostasis","volume":"7","author":"C M Danforth","year":"2012","journal-title":"PLoS One"},{"issue":"19","key":"ref33","doi-asserted-by":"crossref","first-page":"e017316","DOI":"10.1161\/JAHA.120.017316","article-title":"Predictors of bleeding in the perioperative anticoagulant use for surgery evaluation study","volume":"9","author":"A J Tafur","year":"2020","journal-title":"J Am Heart Assoc"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.ahj.2017.09.015","article-title":"Predictors of perioperative major bleeding in patients who interrupt warfarin for an elective surgery or procedure: analysis of the BRIDGE trial","volume":"195","author":"N P Clark","year":"2018","journal-title":"Am Heart J"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.jclinepi.2021.08.001","article-title":"Tutorial on directed acyclic graphs","volume":"142","author":"J C Digitale","year":"2022","journal-title":"J Clin Epidemiol"},{"issue":"04","key":"ref36","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1097\/EDE.0b013e3181a819a1","article-title":"Overadjustment bias and unnecessary adjustment in epidemiologic studies","volume":"20","author":"E F Schisterman","year":"2009","journal-title":"Epidemiology"},{"issue":"10","key":"ref37","doi-asserted-by":"crossref","first-page":"2339","DOI":"10.1002\/sim.8906","article-title":"The impact of adjusting for pure predictors of exposure, mediator, and outcome on the variance of natural direct and indirect effect estimators","volume":"40","author":"A Diop","year":"2021","journal-title":"Stat Med"},{"issue":"01","key":"ref38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1214\/09-STS313","article-title":"Matching methods for causal inference: a review and a look forward","volume":"25","author":"E A Stuart","year":"2010","journal-title":"Stat Sci"},{"issue":"11","key":"ref39","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1093\/aje\/kwr352","article-title":"Invited commentary: understanding bias amplification","volume":"174","author":"J Pearl","year":"2011","journal-title":"Am J Epidemiol"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.cca.2014.12.020","article-title":"Comparison by sex between thrombin generation and fibrin network characteristics in a healthy population","volume":"441","author":"R Marchi","year":"2015","journal-title":"Clin Chim 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analysis","volume":"15","author":"K Imai","year":"2010","journal-title":"Psychol Methods"},{"issue":"02","key":"ref45","doi-asserted-by":"crossref","first-page":"e190","DOI":"10.1055\/s-0038-1649507","article-title":"Mechanistic basis for the differential effects of rivaroxaban and apixaban on global tests of coagulation","volume":"2","author":"P Y Kim","year":"2018","journal-title":"TH Open"},{"issue":"03","key":"ref46","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1097\/AAP.0000000000000763","article-title":"Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine evidence-based guidelines (fourth edition)","volume":"43","author":"T T Horlocker","year":"2018","journal-title":"Reg Anesth Pain Med"},{"issue":"02","key":"ref47","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1111\/j.1538-7836.2010.04146.x","article-title":"Assessment of thrombin generation measured before and 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