Main considerable factors for correct laboratory test interpretation under DOA treatment
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Main considerable factors for correct laboratory test interpretation under DOA treatment Thrombosis Journal 2013, 11:22
doi:10.1186/1477-9560-11-22
Helen Mani ([email protected]) Edelgard Lindhoff-Last ([email protected])
ISSN Article type
1477-9560 Review
Submission date
18 August 2013
Acceptance date
24 September 2013
Publication date
1 November 2013
Article URL
http://www.thrombosisjournal.com/content/11/1/22
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© 2013 Mani and Lindhoff-Last This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Main considerable factors for correct laboratory test interpretation under DOA treatment Helen Mani1* * Corresponding author Email: [email protected] Edelgard Lindhoff-Last1 Email: [email protected] 1
Department of Internal Medicine, Division of Vascular Medicine and Hemostaseology, Johann Wolfgang Goethe-University Hospital, Frankfurt/Main, Germany
Abstract Summary To avoid misinterpretation and mismanagement clinicians should be aware of the interference of new direct oral anticoagulants (DOA) on coagulation assays. A variety of oral anticoagulants targeting specific coagulation factors has already entered the market, and new indications for DOA will be released each year over the next few years. Due to their heterogeneous mode of action and different pharmacokinetic profile each DOA will vary in its effects on coagulations assays, and it is of current importance to recognize these variable effects. In this summary the main considerable factors for correct laboratory test interpretation under DOA treatment are described.
Introduction In multiple clinical situations, coagulation parameters as the prothrombin time (PT) are checked for safe and effective treatment with vitamin K anticoagulants [1]. Global coagulation assays are performed on a routine base even after administration of the new direct oral anticoagulants (DOA), although routine laboratory monitoring is not required [2,3] for these new drugs as dabigatran, rivaroxaban or apixaban. Prolongation of clotting times after DOA administration may raise concerns about the anticoagulant treatment with DOA. As a result, data might be misinterpreted; DOA therapy might be discontinued; and another anticoagulant might be started. Therefore, the main considerable factors for correct laboratory test interpretation under DOA treatment have to be known.
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