Fig. 1

A. Typical “camel-back”-shaped thrombin generation curve obtained in patients treated with rivaroxaban (black curve). In this sample, rivaroxaban concentration was 89 ng/mL. In this sample, lag time was prolonged, and peak height and endogenous thrombin potential (ETP) were decreased compared with the normal control (grey). Lag time and peak height were restored after addition of the [4-]factor PCCs Kanokad® or Confidex® at the doses of 25 and 50 U/kg (0.625 and 1.25 U/mL respectively). Octaplex® did not have any effect in vitro, probably because of the high heparin content in this preparation. ETP was partially restored after PCC addition. Figure 1B. Dose-dependent changes of the in vitro thrombin generation peak in the presence of increasing concentrations of the indicated 4-factor PCCs. The four concentrations (0–15 – 25 – 35 and 50 U.kg^− 1) correspond to the final concentrations of 0–0.375 – 0.625 – 0.875 and 1.25 U.mL^− 1 in plasma samples containing rivaroxaban. Figure 1C. Thrombin generation curve of a sample with low rivaroxaban concentration (48 ng/mL). Before PCC addition, lag time was slightly prolonged, peak height was decreased, and ETP was normal compared with control. Lag time and peak height were restored after addition of the 4-factor PCCs Kanokad® and Confidex® at the dose of 25 U.kg^− 1 (0.625 U/mL). In the rivaroxaban-containing sample, peak height and ETP were higher than in control after spiking with PCC 50 U.kg^− 1 (1.25 U/mL)