Direct oral anticoagulants and antiplatelet agents

D. Sibbing; M. Spannagl

doi:10.5482/HAMO-13-11-0055

Hämostaseologie, Inhaltsverzeichnis

Hamostaseologie 2014; 34(01): 78-84
DOI: 10.5482/HAMO-13-11-0055

Review

Schattauer GmbH

Direct oral anticoagulants and antiplatelet agents

Clinical relevance and options for laboratory testingDirekte orale Antikoagulanzien und ThrombozytenfunktionshemmerKlinische Relevanz und Möglichkeiten der Labordiagnostik

D. Sibbing

¹Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität München

,

M. Spannagl

²Haemostaseologische Ambulanz Campus Innenstadt,, Klinikum der Universität München, Ludwig-Maximilians-Universität München

› Institutsangaben

Abstract

Summary

Oral anticoagulants and platelet receptor blockers are widely used in clinical practice with the aim of reducing the risk of thrombotic complications in patients with cardiovascular diseases. Their regular intake and adequate antithrombotic action is vital and this is way numerous assays have been developed for laboratory testing and monitoring of these agents. Available assays can be stratified into pharmacokinetic and pharmacodynamic assays. Such assays are increasingly used in clinical routine and their daily use is triggered by the advent of the novel direct oral anticoagulants (DOACs) as an alternative for vitamin K antagonist (VKA) treatment, which are dabigatran, rivaroxaban and apixaban, and by the advent of prasugrel or ticagrelor as an alternative for clopidogrel with regard to platelet P2Y₁₂ receptor inhibition.

In this review the most important and most commonly used laboratory assays are summarized as well as their clinical implications with the focus on DOACs as an alternative for VKAs and the different P2Y₁₂ receptor blockers for ant-iplatelet treatment.

Zusammenfassung

Bei Patienten mit kardiovaskulären Krankheiten werden orale Antikoagulanzien und Thrombozytenaggregationshemmer häufig verwendet, um das Risiko für thrombotische Ereignisse zu reduzieren. Die regelmäßige Einnahme und suffiziente antithrombozytäre Wirkung ist ganz entscheidend für den einzelnen Patienten. Aus diesem Grund wurden pharmakinetische und pharmakodynamische Testverfahren entwickelt, um die Wirkung dieser Medikamente zu monitorieren. In der klinischen Routine finden diese Verfahren immer häufiger Anwendung. Ihre Verbreitung wird auch durch die Verfügbarkeit so genannter neuer direkter oraler Antikoagulanzien wie Dabigatran, Rivaroxaban und Apixaban als Alternative zu Vitamin-K-Antagonisten und neuer Plättchenaggregationshemmer wie Prasugrel und Ticagrelor als Alternative zu Clopidogrel unterstützt.

In dieser Übersichtsarbeit werden die wichtigsten und häufigsten Verfahren und ihre klinischen Implikationen in Bezug auf das Antikoagulanzien-und Plättchenaggregationshemmer-Monitoring vorgestellt.

Keywords

Oral anticoagulation - platelet aggregation - drug monitoring

Schlüsselwörter

Orale Antikoagulanzien - Plättchenaggregation - Drug-Monitoring

Volltext

Referenzen

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