Dergiler / International Journal of Medical Biochemistry / 2019 / Cilt: 2 - Sayı: 2

New generation oral anticoagulants may cause unreliable results in routine coagulation testing

Sayfa
35–40
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

It will be of great benefit for clinicians to communicate with laboratory specialists in the follow-up of patients who are other than traditional anticoagulation cases.

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Amaç & Hipotez:Objectives: The aim of this study was to raise awareness among laboratory staff and physicians that prothrombin timeinternational normalized ratio (PT-INR) tests are not reliable in patients receiving direct oral anticoagulant treatment and, in particular, dabigatran.
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Temel Bulgular & Veri:Methods: PT-INR tests were performed on 151 plasma specimens using 3 coagulation analyzers with different methodologies: (i) the Thrombolyzer XRM (Behnk Elektronik GmbH & Co.
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Sonuç & Katkı:It will be of great benefit for clinicians to communicate with laboratory specialists in the follow-up of patients who are other than traditional anticoagulation cases.
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Objectives: The aim of this study was to raise awareness among laboratory staff and physicians that prothrombin timeinternational normalized ratio (PT-INR) tests are not reliable in patients receiving direct oral anticoagulant treatment and, in particular, dabigatran. Methods: PT-INR tests were performed on 151 plasma specimens using 3 coagulation analyzers with different methodologies: (i) the Thrombolyzer XRM (Behnk Elektronik GmbH & Co. KG, Norderstedt, Germany), which uses the optomechanical method; (ii) the Diagon CoagXL (Diagon Ltd., Budapest, Hungary), which uses the optical method; and (iii) the reference method for the study, the Stago STA Compact (Diagnostica Stago SAS., Asnières sur Seine Cedex, France), which uses the mechanical method. All of the results were analyzed using the intraclass correlation coefficient (ICC), Passing-Bablok regression analysis, and Bland-Altman analysis to examine the consistency of measurement techniques. Unacceptable results were observed for accuracy and precision when the analysis included 23 patients who were using the new generation oral anticoagulant dabigatran. Results: The Stago STA Compact-Thrombolyzer PT-INR ICC was higher than that of Stago STA Compact-Diagon CoagXL, with a narrow 95% confidence interval. Passing-Bablok regression analysis of all of the results revealed a significant deviation from linearity (p<0.01), but there was no significant deviation from linearity when the results of the patients using dabigatran were excluded. Once the patients using dabigatran were excluded, the results of the comparison studies reached more acceptable limits. Conclusion: It was determined that the use of a new generation oral anticoagulant (dabigatran) was a source of preanalytical error. It will be of great benefit for clinicians to communicate with laboratory specialists in the follow-up of patients who are other than traditional anticoagulation cases.

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Bu Makaleye Atıf Yap

GEDİKBAŞI, A., ÇİÇEK, Y. G., NEİJMANN, Ş. T., ERDİN, S., IŞIKSAÇAN, N., ÇIRAKLI, Z. L., KURAL, A. (2019). New generation oral anticoagulants may cause unreliable results in routine coagulation testing. International Journal of Medical Biochemistry, Cilt: 2 - Sayı: 2, 35–40. https://ajindex.com/articles/159420

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Kaynakça (12)

  1. Burnett AE, Mahan CE, Vazquez SR, Oertel LB, Garcia DA, Ansell J. Guidance for the practical management of the direct oral anticoagulants (DOACs) in VTE treatment. J Thromb Thrombolysis 2016;41:206–32. 2. van Es N, Coppens M, Schulman S, Middeldorp S, Büller HR. Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: evidence from phase 3 trials. Blood 2014;124:1968–75
  2. Favaloro EJ, Pasalic L, Curnow J, Lippi G. Laboratory Monitoring or Measurement of Direct Oral Anticoagulants (DOACs): Advantages, Limitations and Future Challenges. Curr Drug Metab 2017;18:598–608
  3. Schmitz EM, Boonen K, van den Heuvel DJ, van Dongen JL, Schellings MW, Emmen JM, et al. Determination of dabigatran, rivaroxaban and apixaban by ultra-performance liquid chromatography - tandem mass spectrometry (UPLC-MS/ MS) and coagulation assays for therapy monitoring of novel direct oral anticoagulants. J Thromb Haemost 2014;12:1636– 46
  4. Dale BJ, Chan NC, Eikelboom JW. Laboratory measurement of the direct oral anticoagulants. Br J Haematol 2016;172:315– 36
  5. Giavarina D. Understanding Bland Altman analysis. Biochem Med (Zagreb) 2015;25:141–51
  6. Adcock DM, Gosselin R. Direct Oral Anticoagulants (DOACs) in the Laboratory: 2015 Review. Thromb Res 2015;136:7–12
  7. Douxfils J, Ageno W, Samama CM, Lessire S, Ten Cate H, Verhamme P, et al. Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians. J Thromb Haemost 2018;16:209–19
  8. Eikelboom JW, Quinlan DJ, Hirsh J, Connolly SJ, Weitz JI. Laboratory Monitoring of Non-Vitamin K Antagonist Oral Anticoagulant Use in Patients With Atrial Fibrillation: A Review. JAMA Cardiol 2017;2:566–74
  9. Samuelson BT, Cuker A, Siegal DM, Crowther M, Garcia DA. Laboratory Assessment of the Anticoagulant Activity of Direct Oral Anticoagulants: A Systematic Review. Chest 2017;151:127–38
  10. Mijovski MB. Advances in monitoring anticoagulant therapy. Advances in Clinical Chemistry 2019;90:1–17
  11. Steiner T, Böhm M, Dichgans M, Diener HC, Ell C, Endres M, et al. Recommendations for the emergency management of complications associated with the new direct oral anticoagulants (DOACs), apixaban, dabigatran and rivaroxaban. Clin Res Cardiol 2013;102:399–412
  12. Singh T, Maw TT, Henry BL, Pastor-Soler NM, Unruh ML, Hallows KR, et al. Extracorporeal therapy for dabigatran removal in the treatment of acute bleeding: a single center experience. Clin J Am Soc Nephrol 201