Point-of-Care Coagulation Tests Monitoring of Direct Oral Anticoagulants and Their Reversal Therapy: State of the Art

Giacomo E. Iapichino, Giacomo E. Iapichino, Paolo Bianchi, Marco Ranucci, Ekaterina Baryshnikova

Research output: Contribution to journalArticle

Abstract

Copyright © 2017 by Thieme Medical Publishers, Inc. Direct oral anticoagulants (DOACs) exert similar anticoagulant effects to vitamin K antagonists and are increasingly used worldwide. Nevertheless, an evidence-based approach to patients receiving DOACs when any unplanned urgent surgery or bleeding (either spontaneous or traumatic) occurs is still missing. In this review, we investigate the role of point-of-care coagulation tests when other, more specific tests are not available. Indeed, thromboelastography and activated clotting time can detect dabigatran-induced coagulopathy, while their accuracy is limited for apixaban and rivaroxaban, mostly in cases of low drug plasma concentrations. These tests can also be used to guide the reversal of DOAC-induced coagulopathy providing a quick, before-and-after picture in case of therapeutic use of hemostatic compounds.
Original languageEnglish
Pages (from-to)423-432
Number of pages10
JournalSeminars in Thrombosis and Hemostasis
Volume43
Issue number4
DOIs
Publication statusPublished - Jun 1 2017

Keywords

  • dabigatran
  • DOACs
  • FXa inhibitors
  • thromboelastography
  • thromboelastometry

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