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Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

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Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
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Different methods, such as visual observance of metal-ion indicators, spectroscopic techniques, and potentiometric methods, can determine the endpoint of an EDTA titration.
In the visual method, metal-ion indicators (metallochromic dyes), which have distinct colors in their free and complex forms, are added to the mixture to signal the titration's end point. They form stable complexes with metal ions, but these complexes are weaker than the corresponding metal–EDTA complexes. As a...
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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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EDTA: Indirect and Alkalimetric Titration01:23

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Unlike direct titration, back-titration, and displacement titration, indirect titration is an EDTA titration method for quantifying anions. In the indirect titration method, anions are precipitated as their insoluble salts with excess metal ions. The filtrate containing the excess metal ions is directly titrated with standard EDTA until the endpoint is achieved. Another approach involves extracting the metal ion and back-titrating with standard EDTA to obtain the endpoint. In this way, the...
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Alternative drug dissolution methods include the rotating bottle, intrinsic dissolution test, peristalsis, and the Franz diffusion cell method. The rotating bottle method involves meticulously rotating tightly capped controlled-release beads in a temperature-controlled bath. Periodic decanting of samples allows for residue assay, followed by refilling with fresh medium and testing at various pH levels to emulate the gastrointestinal tract conditions.In contrast, the intrinsic dissolution test...
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Viscoelastometry for detecting oral anticoagulants.

Philipp Groene1, Daniela Wagner2, Tobias Kammerer2,3

  • 1Department of Anaesthesiology, University Hospital Munich, LMU Munich, Marchioninistraße 15, 81377, Munich, Germany. philipp.groene@med.uni-muenchen.de.

Thrombosis Journal
|March 17, 2021
PubMed
Summary
This summary is machine-generated.

Viscoelastometric assays using the ClotPro device can help identify anticoagulant classes in emergency settings. Specific tests show high sensitivity and specificity for detecting dabigatran and factor Xa inhibitors.

Keywords:
AnticoagulantsCoagulation testsDabigatranFactor Xa (FXa) inhibitorsHeparinViscoelastometry

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Area of Science:

  • Hemostasis and Thrombosis Research
  • Clinical Diagnostics
  • Pharmacology

Background:

  • Routine coagulation tests offer limited insight into anticoagulant therapy in emergencies.
  • Viscoelastometric assays provide a more comprehensive assessment of hemostasis.
  • The impact of various anticoagulants on ClotPro device assays requires detailed investigation.

Purpose of the Study:

  • To evaluate the influence of different anticoagulant classes on viscoelastometric assay results.
  • To determine the diagnostic utility of ClotPro assays for identifying specific anticoagulants in emergency situations.
  • To assess the correlation between anticoagulant plasma concentrations and viscoelastometric parameters.

Main Methods:

  • Prospective observational study involving patients on dabigatran, FXa inhibitors, phenprocoumon, LMWH, or UFH, and healthy volunteers.
  • Performance of multiple viscoelastometric assays: EX-test, IN-test, RVV-test, ECA-test, and TPA-test.
  • Correlation analysis between assay results, anticoagulant plasma concentrations, and diagnostic accuracy.

Main Results:

  • Significant prolongation of clotting times (CT) observed across various tests with different anticoagulants compared to controls.
  • The ecarin test (ECA-test) demonstrated 100% sensitivity and specificity for dabigatran detection, correlating strongly with anti-IIa activity.
  • The Russel's viper venom test (RVV-test) showed good sensitivity (83%) and moderate specificity (64%) for detecting FXa inhibitors, correlating with anti-Xa activity.

Conclusions:

  • ClotPro viscoelastometric assays can aid in determining the presence and class of anticoagulants in emergency settings.
  • The ECA-test is highly effective for identifying dabigatran use.
  • The RVV-test shows potential for detecting FXa inhibitors, warranting further clinical validation.