Direct oral anticoagulants: When to consider laboratory testing?
H Ten Cate1,2,3, R H Olie1,2, A J Ten Cate-Hoek2,4
1Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands.
International Journal of Laboratory Hematology
|May 10, 2018
Summary
Direct oral anticoagulants (DOACs) testing can clarify acute situations like bleeding or thrombosis. Laboratory guidance for DOAC management, especially in the elderly, requires further investigation.
Area of Science:
- Pharmacology
- Clinical Medicine
- Laboratory Diagnostics
Background:
- Direct oral anticoagulants (DOACs) are widely used for stroke prevention and venous thromboembolism.
- Routine laboratory testing for DOAC dose adjustment is not typically required.
- Specific clinical scenarios necessitate understanding DOAC plasma activity levels.
Purpose of the Study:
- To discuss indications for dedicated DOAC testing.
- To explore the interpretation and clinical consequences of DOAC testing.
- To highlight the utility of DOAC assays in patient management.
Main Methods:
- Analysis of real-life case descriptions.
- Review of indications for DOAC testing.
- Discussion of test interpretation and management implications.
Main Results:
- DOAC testing aids in interpreting acute bleeding or thrombosis.
- Testing can identify suspected drug failure, accumulation, or non-adherence.
- Laboratory assessment provides valuable insights in specific patient cases.
Conclusions:
- 24/7 availability of calibrated DOAC tests is recommended for clinical support.
- Laboratory-guided management of DOACs may improve patient outcomes.
- Further research is needed on laboratory-guided DOAC management in elderly populations.
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