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Laboratory measurement of the direct oral anticoagulants

2015; Wiley; Volume: 172; Issue: 3 Linguagem: Inglês

10.1111/bjh.13810

1365-2141

Brian Dale, Noel Chan, John W. Eikelboom,

Acute Myocardial Infarction Research

Summary Direct oral anticoagulants ( DOAC s), including the direct thrombin inhibitor, dabigatran, and the direct factor Xa ( FX a) inhibitors, rivaroxaban, apixaban and edoxaban, are approved for thromboembolism prevention and treatment. These drugs do not require routine coagulation monitoring but, in some circumstances, measurement of drug level or anticoagulant effect may be necessary. Although traditional coagulation tests lack analytical sensitivity and specificity, they are widely available and inexpensive, and can provide useful information regarding the residual anticoagulant effect of DOAC s. Hemoclot ® and ecarin‐based assays can be used to quantify dabigatran level and calibrated chromogenic anti‐ FX a assays are suitable for measuring rivaroxaban, apixaban and edoxaban levels, but these tests are not yet widely available.