A New Test for the Detection of Direct Oral Anticoagulants (Rivaroxaban and Apixaban) in the Emergency Room Setting

Gh, Frydman; Ellett, Felix; Em, Van Cott; Hayden, Douglas; Majmudar, Maulik D.; Cr, Vanderburg; H, Dalzell; Dl, Padmanabhan; Davis, Nicole R.; Jorgensen, Julianne; Toner, Mehmet; Jg, Fox; Rg, Tompkins

doi:10.1097/cce.0000000000000024

Cited by 8 publications

(4 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[96][97][98] Included are microfluidic technologies [98][99][100][101] and surface acoustic wave (SAW) technologies. 102 Although the preliminary findings are promising, shortcomings include use of an animal model, 101 or in vitro enriched DOAC blood, 99 data from a small series of patients 99,100 and only a limited number of DOACs assessed. 99,101,102 In addition, these methods appear to be several years from actual clinical implementation, as none have undergone the rigors of in vitro device (IVD) clinical trials.…”

Section: Doac Point-of-care Testingmentioning

confidence: 99%

“…The widespread use of DOACs and the need for urgent determination in aforementioned specific clinical situations have spurred several investigators and manufacturers to pursue POCT technologies for measuring (or quantifying) DOAC effect. [96][97][98] Included are microfluidic technologies [98][99][100][101] and surface acoustic wave (SAW) technologies. 102 Although the preliminary findings are promising, shortcomings include use of an animal model, 101 or in vitro enriched DOAC blood, 99 data from a small series of patients 99,100 and only a limited number of DOACs assessed.…”

Section: Doac Point-of-care Testingmentioning

confidence: 99%

See 1 more Smart Citation

2021 Update of the International Council for Standardization in Haematology Recommendations for Laboratory Measurement of Direct Oral Anticoagulants

Adcock²,

et al. 2021

View full text Add to dashboard Cite

In 2018, the International Council for Standardization in Hematology (ICSH) published a consensus document providing guidance for laboratories on measuring direct oral anticoagulants (DOACs). Since that publication, several significant changes related to DOACs have occurred, including the approval of a new DOAC by the Food and Drug Administration, betrixaban, and a specific DOAC reversal agent intended for use when the reversal of anticoagulation with apixaban or rivaroxaban is needed due to life-threatening or uncontrolled bleeding, andexanet alpha. In addition, this ICSH Working Party recognized areas where additional information was warranted, including patient population considerations and updates in point-of-care testing. The information in this manuscript supplements our previous ICSH DOAC laboratory guidance document. The recommendations provided are based on (1) information from peer-reviewed publications about laboratory measurement of DOACs, (2) contributing author’s personal experience/expert opinion and (3) good laboratory practice.

show abstract

Section: Doac Point-of-care Testingmentioning

confidence: 99%

Section: Doac Point-of-care Testingmentioning

confidence: 99%

2021 Update of the International Council for Standardization in Haematology Recommendations for Laboratory Measurement of Direct Oral Anticoagulants

Adcock²,

et al. 2021

View full text Add to dashboard Cite

show abstract

“…A CTS, a unitless value, was calculated for control and patient samples as previously described (30). Briefly, coagulation curves for UFH and bivalirudin were derived based on clotting times ( Fig.…”

Section: Methodsmentioning

confidence: 99%

Novel Coagulation Test Detects Anticoagulation Resistance and Is Associated With Thrombotic Events in Pediatric Patients Requiring Extracorporeal Membrane Oxygenation

Frydman¹,

Berger²,

Kostousov

et al. 2022

Critical Care Explorations

Self Cite

View full text Add to dashboard Cite

OBJECTIVES:Bivalirudin, an IV direct thrombin inhibitor, and unfractionated heparin (UFH) are frequently used anticoagulants in the pediatric critical care setting. An accurate, specific, point-of-care test to quantify and detect anticoagulation resistance is not currently available. This study evaluates the ability of a rapid (< 10 min), micro-volume (< 50 uL) coagulation test to detect and quantify the anticoagulation effect of bivalirudin and UFH using a functional, clot time endpoint in pediatric critical care patients. DESIGN:Single-site retrospective laboratory sample analysis and chart review. SETTING:A 105-bed pediatric and cardiac ICUs delivering extracorporeal membrane oxygenation.SUBJECTS: Forty-one citrated, frozen, biobanked plasma specimens comprising 21 with bivalirudin and 20 with UFH from 15 anticoagulated pediatric patients were analyzed. Thirteen patients were on extracorporeal membrane oxygenation, one had a submassive pulmonary embolism, and one was on a left ventricular assist device. INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS:A Clotting Time Score (CTS) was derived on each sample. The CTS detected patients that had developed a pathologic clotting event with 100% sensitivity and 82% specificity compared with prothrombin time with 25% sensitivity/76% specificity and activated partial thromboplastin time with 0% sensitivity/0% specificity. Additionally, the CTS detected subtherapeutic anticoagulation in response to UFH in patients that were clinically determined to be UFH resistant requiring alternative anticoagulation with bivalirudin. CONCLUSIONS:The CTS appears to be a clinically valuable indicator of coagulation status in patients treated with either UFH or bivalirudin. Results outside of the therapeutic range due to inadequate dosing or anticoagulation resistance appeared to be associated with clot formation. CTS testing may reduce the risk of anticoagulation-related complications via the rapid identification of patients at high risk for pathologic thrombotic events.

show abstract

“…Высокая стоимость оборудования и реактивов и необходимость специальной подготовки кадров препятствуют определению данных показателей в экстренных ситуациях. Чтобы устранить эти ограничения, был разработан анализ на основе микрофлюидных методов, позволяющий обнаружить присутствие FXa-I в образцах крови [44]. Но данный метод пока не прошел клиническую апробацию.…”

Section: возможности мониторинга эффективности и безопасности антикоагулянтной терапииunclassified

Efficacy and safety of Xa factor antagonists in patients with nonvalvular atrial fibrillation

Drozdovа¹,

Kochetkovaа²

2021

CPT

View full text Add to dashboard Cite

Factor Xa antagonists are used increasingly frequently for prevention and treatment of venous thromboembolic events and for prevention of stroke and systemic emboli in patients with non-valvular atrial fibrillation. Individual characteristics of patient, a need in prolonged or life-long treatment, concomitant diseases, the use of other drugs interacting with anticoagulants increase the risk of side effects of anticoagulation. We analyzed the current data on the efficacy and safety of Xa factor antagonists, as well as the features of their use in the event of adverse reactions, particularly bleedings. The possibilities of monitoring the efficacy and safety of treatment with these drugs were evaluated.

show abstract

A New Test for the Detection of Direct Oral Anticoagulants (Rivaroxaban and Apixaban) in the Emergency Room Setting

Cited by 8 publications

References 43 publications

2021 Update of the International Council for Standardization in Haematology Recommendations for Laboratory Measurement of Direct Oral Anticoagulants

2021 Update of the International Council for Standardization in Haematology Recommendations for Laboratory Measurement of Direct Oral Anticoagulants

Novel Coagulation Test Detects Anticoagulation Resistance and Is Associated With Thrombotic Events in Pediatric Patients Requiring Extracorporeal Membrane Oxygenation

Efficacy and safety of Xa factor antagonists in patients with nonvalvular atrial fibrillation

Contact Info

Product

Resources

About