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[Monitoring of Oral Thrombin Inhibitor].
Rinsho Byori. the Japanese Journal of Clinical Pathology
|August 17, 2016
Summary
Dabigatran etexilate monitoring is not routine, but special coagulation assays can assess its effect. Activated partial thromboplastin time (APTT) and prothrombin time (PT) correlate with dabigatran levels, aiding in plasma estimation.
Area of Science:
- Pharmacology
- Hematology
- Clinical Chemistry
Context:
- Dabigatran etexilate, a direct thrombin inhibitor, is used for stroke prevention in non-valvular atrial fibrillation.
- Routine laboratory monitoring is not required, but assessment is desirable in specific clinical situations like bleeding or overdose.
- Specialized coagulation assays exist for evaluating dabigatran's anticoagulant effect.
Purpose:
- To review specialized coagulation assays for assessing dabigatran's anticoagulant activity.
- To examine the correlation between dabigatran plasma levels and standard coagulation tests.
- To determine if routine tests can estimate dabigatran levels.
Summary:
- Dabigatran etexilate is converted to dabigatran, a direct thrombin inhibitor.
- Specialized assays like Hemoclot Thrombin Inhibitor (HTI) can measure dabigatran levels.
- Activated partial thromboplastin time (APTT) and prothrombin time (PT) show a positive correlation with dabigatran levels.
Impact:
- APTT and PT, individually or combined, may serve as useful tools for estimating dabigatran plasma levels.
- This finding could aid clinicians in managing patients requiring dabigatran therapy, especially when specialized assays are unavailable.
- Provides insights into the utility of routine coagulation tests for monitoring novel oral anticoagulants.
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