- Title
- Sensitivity of routine coagulation assays to direct oral anticoagulants: patient samples versus commercial drug-specific calibrators
- Creator
- Lim, Ming Sheng; Chapman, Kent; Swanepoel, Priscilla; Enjeti, Anoop K.
- Relation
- Pathology Vol. 48, Issue 7, p. 712-719
- Publisher Link
- http://dx.doi.org/10.1016/j.pathol.2016.07.008
- Publisher
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Date
- 2016
- Description
- Most studies on the sensitivities of coagulation assays to direct oral anticoagulants (DOACs) are based on normal plasma spiked with anticoagulant in the laboratory. Recent studies have shown that reagent sensitivity varies significantly depending on whether spiked or patient samples are used. The aim of this study was to compare the sensitivities of routine coagulation assays in patient samples and commercial drug specific calibrators using commonly used activated partial thromboplastin time (APTT) and prothrombin time (PT) reagents (i.e., Actin FS and Neoplastine CI Plus for APTT and PT, respectively) in Australian laboratories. Samples collected at Pathology North Hunter (PN-H) for dabigatran (n = 39), rivaroxaban, (n = 56) or apixaban levels (n = 22) between February 2013 and November 2015 were analysed and compared to two different commercial drug specific calibrators from different manufacturers for each DOAC. Our results show that dabigatran (Hyphen and Technoclone) and rivaroxaban (Stago) calibrators tend to overestimate the APTT but are similar to patient samples for PT. A cut-off DOAC level of 50 ng/mL based on results from patient samples within the laboratory can be used as the lower limit which will result in prolongation of APTT for dabigatran (sensitivity 96%, n = 25) and PT for rivaroxaban (sensitivity 97%, n = 29), respectively. Individual laboratories should be familiar with the sensitivity of their coagulation reagents to different DOACs including differences between patient samples versus different commercial drug specific calibrators.
- Subject
- direct oral anticoagulants; DOACs; activated partial thromboplastin time; prothrombin time; patient samples; calibrators
- Identifier
- http://hdl.handle.net/1959.13/1345653
- Identifier
- uon:29691
- Identifier
- ISSN:0031-3025
- Rights
- This article is available under the terms of the Creative Commons Attribution License (CC BY). You may copy and distribute the article, create extracts, abstracts and new works from the article, alter and revise the article, text or data mine the article and otherwise reuse the article commercially (including reuse and/or resale of the article) without permission from Elsevier. You must give appropriate credit to the original work, together with a link to the formal publication through the relevant DOI and a link to the Creative Commons user license above. You must indicate if any changes are made but not in any way that suggests the licensor endorses you or your use of the work.
- Language
- eng
- Full Text
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