Monitoring target-specific oral anticoagulants

Abstract

Target-specific oral anticoagulants are approved for use for the prevention of stroke in atrial fibrillation and for the prevention and treatment of venous thrombosis without the need for laboratory monitoring. However, there are clinical settings in which laboratory measurement of anticoagulant effect is needed. These may include patients with life-threatening bleeding or those requiring emergency surgery, in the setting of renal or hepatic failure, or patients with thrombosis on therapy. This chapter reviews the use of laboratory testing to assess the anticoagulant effect of these drugs. In addition, because these drugs can interfere with other laboratory testing, available data on these interactions are presented. Learning Objectives• To understand the effect of TSOACs on laboratory screening tests and specific tests developed to measure their activity • To understand the effects of TSOACs on other coagulation testing

Evaluation of global laboratory methods and establishing on‐therapy ranges for monitoring apixaban and rivaroxaban: Experience at a single institution

“…However, PT does not always predictably reflect the anticoagulant activity of rivaroxaban, and the sensitivity of PT to rivaroxaban depends on the laboratory reagents used . APTT was less sensitive to apixaban and rivaroxaban than PT, which concurs with previous reports . In the present study, APTT was well correlated with plasma rivaroxaban levels in patients treated with rivaroxaban at 15 mg OD.…”

“…16,27,28 APTT was less sensitive to apixaban and rivaroxaban than PT, which concurs with previous reports. 24,25 In the present study, APTT was well correlated with plasma rivaroxaban levels in patients treated with rivaroxaban ( Table 4). 27 Neither D-dimer nor FDP exhibited correlations with apixaban or rivaroxaban concentration.…”