Effect of direct oral anticoagulants on the hemostasis system 142 in bacterial sepsis

The inflammatory reaction that arises in patients with sepsis is interconnected with the coagulation system and leads to the development of hypercoagulable changes in the body. Therefore, in this study, we studied the effect of direct oral anticoagulants dabigatran etexilate and apixaban on the hemostasis system without and under conditions of a systemic inflammatory response. Hypercytokinemia was created by intravenous administration of lipopolysaccharide into the tail vein of a rat. The anticoagulant activity of the studied drugs was assessed by their effect on the parameters of the rat blood coagulogram. Dabigatran etexilate showed a pronounced antithrombin effect, increasing the thrombin time by 10.5 times relative to the control in intact animals. Under conditions of hypercytokinemia, this activity increased by 12.8 times. Apixaban did not cause changes in thrombin time, but it increased the prothrombin time index both in intact animals and animals with a systemic inflammatory response by 7 and 8.6 times, respectively. Thus, an increase in the anticoagulant effect of dabigatran etexilate and apixaban under conditions of hypercytokinemia indicates that they may have anti-inflammatory activity.