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Semin Thromb Hemost 2014; 40(01): 129-134
DOI: 10.1055/s-0033-1363462
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Determination of Direct Oral Anticoagulants from Human Serum Samples

Job Harenberg
1   Department of Clinical Pharmacology Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Sandra Kraemer
1   Department of Clinical Pharmacology Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Shanshan Du
1   Department of Clinical Pharmacology Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Christina Giese
1   Department of Clinical Pharmacology Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Astrid Schulze
2   Department of Orthopedic and Trauma Surgery, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
,
Roland Kraemer
3   Inorganic Chemistry Institute, University of Heidelberg, Heidelberg, Germany
,
Christel Weiss
4   Department of Biometry and Statistics, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
31 December 2013 (online)

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Abstract

Dabigatran, rivaroxaban, and apixaban are direct oral anticoagulants (DOAC) inhibiting thrombin or factor Xa and effectively preventing thromboembolic complications using fixed doses without need for laboratory-guided dose adjustment. Plasma samples are needed to determine the actual concentration or activity of DOACs, which may be required for special patient populations such as those with acute deterioration of renal function due to any disease, before surgical interventions, during bleeding or thrombotic episodes while on therapy with DOACs, the elderly and youngest populations, unexpected pregnancy, suspicion of overdose and toxication, and to control adherence to therapy. Serum samples have several advantages over plasma samples such as no need of sampling with a specific coagulation tube, reduced pre-analytical errors, and longer storage stability. Determination of rivaroxaban and apixaban from serum samples of patients on treatment performed well and better than samples of patients treated with dabigatran compared with plasma samples. Specific adaption to automated coagulation platforms may improve the performance of the assays from serum samples.

Keywords

direct oral anticoagulants - dabigatran - rivaroxaban - apixaban - serum - methods
 

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