Prothrombin Time Tests for the Monitoring of Direct Oral Anticoagulants and Their Evaluation as Indicators of the Reversal Effect
| Autor: | Kunihiko Nagakari, Toshiaki Iba, Mari Emmi |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Pyridines Pyridones 030204 cardiovascular system & hematology Care setting 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Rivaroxaban Edoxaban medicine Humans 030212 general & internal medicine Reversal effect Intensive care medicine Blood Coagulation Prothrombin time medicine.diagnostic_test business.industry Anticoagulants Hematology General Medicine Blood Coagulation Factors Thiazoles chemistry Anesthesia Prothrombin Time Pyrazoles Apixaban Drug Monitoring business medicine.drug |
| Zdroj: | Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. 23(6) |
| ISSN: | 1938-2723 |
| Popis: | Introduction: The prompt assessment and the reversal of direct oral anticoagulants (DOACs) are urgent matters in the emergency care setting. Thus, we planned to elucidate the adequate prothrombin time (PT) test for the evaluation of the anticoagulant effects of various DOACs. Methods: The anticoagulant effects of rivaroxaban, apixaban, and edoxaban were measured with 3 PT tests (Triniclot PT Excel S, Neoplastin R, and Thromborel S). Human plasma was spiked with each DOAC at a range of 0 to 1000 ng/mL, and the PT was measured using each PT test. In another series, the reversal effect of either 4-factor prothrombin complex concentrate (PCC) or activated PCC (aPCC) was evaluated with each PT test. Results: All PT reagents correlated with the concentrations of each DOAC, however, the reactivity was considerably different between the DOACs and the PT tests. A prolonged PT with DOACs was reversed both by PCC and aPCC in a dose-dependent manner; however, Triniclot PT Excel S showed reprolongation of the PT with a higher dose of PCC. Conclusion: The proper choice of PT test is necessary for the assessments of the anticoagulant activity of DOACs. It is also important to understand the different characteristics of each PT test for the assessment of the reversal effects of PCC. |
| Databáze: | OpenAIRE |
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