Özet:

Introduction: New generation oral anticoagulants (NOACs), which selectively and reversibly block the activity of clotting factor Xa, are now preferred as first-line therapy for preventing ischemic stroke in the treatment of atrial fibrillation (AF). Edoxaban, one of these NOACs, has been shown to be as effective as warfarin in preventing stroke or systemic embolism, while carrying a lower risk of bleeding and cardiovascular death. Mean platelet volume (MPV), as an indicator of platelet activity, is associated with an increased risk of ischemic stroke in patients with AF. Therefore, medical therapies that reduce MPV may play an important role in preventing unwanted ischemic events. Objective: The aim of this study is to determine whether edoxaban has an effect on platelet volume and other platelet indices, in addition to its protective anticoagulant effect against ischemic stroke. Materials and Methods: The study was designed as a retrospective cross-sectional study. Two hundred non-valvular AF patients without a history of oral anticoagulant use were included in the study. Complete blood count (CBC) and basic biochemical parameters (urea, creatinine, electrolytes, etc.) were recorded from the hospital registration system before edoxaban treatment was started, along with basic demographic data. The CBCs of the patients were reevaluated an average of 6 months (184 ± 9 days) after edoxaban treatment initiation, and platelet indices after edoxaban treatment were compared. Results were presented as mean ± standard deviation and percentage. Data were compared using Student's t-test and Wilcoxon test, and p<0.05 was considered statistically significant. Results: The mean age of the patients was 74±9 years. The majority of the patients in the study were female (52.5%). A significant increase in MPV value was observed after treatment [10.0 fL (6.0-13.8) vs. 10.2 fL (7.1-14.9), p=0.023], considering the change in MPV values of the patients. This increase in MPV was not observed in the group using 30mg/day edoxaban (p=0.333), while a significant increase was observed in the group using 60mg/day (p=0.041). In addition, no gender-related change was observed in MPV. No significant changes were observed in platelet count (PLT) (p=0.863), platelet distribution width (PDW) (p=0.085), or plateletcrit (PCT) (p=0.127) values during the six-month period of edoxaban use. Conclusion: The observed increase in mean platelet volume suggests that edoxaban may have unknown pleiotropic effects on platelet indices, and further studies are needed to determine whether this increase in MPV has any clinical significance.

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