A novel prothrombin time method to measure all non-vitamin K-dependent oral anticoagulants (NOACs)
| Autor: | Maria Wallstedt, Mats Rånby, Tomas L. Lindahl, Kerstin Arbring |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Vitamin K medicine.drug_class apixaban Administration Oral lcsh:Medicine 030204 cardiovascular system & hematology Pharmacology Vitamin k Dabigatran 03 medical and health sciences 0302 clinical medicine Limit of Detection Humans Medicine dabigatran International Normalized Ratio rivaroxaban Prothrombin time Rivaroxaban medicine.diagnostic_test business.industry Anticoagulant lcsh:R Temperature Klinisk medicin Anticoagulants Original Articles General Medicine prothrombin time 030104 developmental biology Apixaban Clinical Medicine business medicine.drug |
| Zdroj: | Upsala Journal of Medical Sciences, Vol 122, Iss 3, Pp 171-176 (2017) Upsala Journal of Medical Sciences |
| DOI: | 10.6084/m9.figshare.5394835 |
| Popis: | Background: There is a clinical need for point-of-care (POC) methods for non-vitamin K-dependent oral anticoagulants (NOACs). We modified a routine POC procedure: Zafena’s Simple Simon™ PT-INR, a room-temperature, wet-chemistry prothrombin time method of the Owren-type. Methods: To either increase or decrease NOAC interference, two assay variants were devised by replacing the standard 10 µL end-to-end capillary used to add the citrated plasma sample to 200 µL of prothrombin time (PT) reagent by either a 20 µL or a 5 µL capillary. All assay variants were calibrated to show correct PT results in plasma samples from healthy and warfarin-treated persons. Results: For plasmas spiked with dabigatran, apixaban, or rivaroxaban, the 20 µL variant showed markedly higher PT results than the 5 µL. The effects were even more pronounced at room temperature than at +37 °C. In plasmas from patients treated with NOACs (n = 30 for each) there was a strong correlation between the PT results and the concentration of NOACs as determined by the central hospital laboratory. For the 20 µL variant the PT response of linear correlation coefficient averaged 0.90. The PT range was INR 1.1–2.1 for dabigatran and apixaban, and INR 1.1–5.0 for rivaroxaban. Using an INR ratio between the 20 µL and 5 µL variants (PTr20/5) made the NOAC assay more robust and independent of the patient sample INR value in the absence of NOAC. Detection limits were 80 µg/L for apixaban, 60 µg/L for dabigatran, and 20 µg/L for rivaroxaban. Conclusions: A wet-chemistry POC PT procedure was modified to measure the concentrations of three NOACs using a single reagent. Funding agencies: county of Ostergotland research funds [LIO-609911] |
| Databáze: | OpenAIRE |
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