Algorithm for Rapid Exclusion of Clinically Relevant Plasma Levels of Direct Oral Anticoagulants in Patients Using the DOAC Dipstick : An Expert Consensus Paper
Thieme. All rights reserved..
BACKGROUND: With the widespread use of direct oral anticoagulants (DOACs), there is an urgent need for a rapid assay to exclude clinically relevant plasma levels. Accurate and rapid determination of DOAC levels would guide medical decision-making to (1) determine the potential contribution of the DOAC to spontaneous or trauma-induced hemorrhage; (2) identify appropriate candidates for reversal, or (3) optimize the timing of urgent surgery or intervention.
METHODS AND RESULTS: The DOAC Dipstick test uses a disposable strip to identify factor Xa- or thrombin inhibitors in a urine sample. Based on the results of a systematic literature search followed by an analysis of a simple pooling of five retrieved clinical studies, the test strip has a high sensitivity and an acceptably high negative predictive value when compared with levels measured with liquid chromatography tandem mass spectrometry or calibrated chromogenic assays to reliably exclude plasma DOAC concentrations ≥30 ng/mL.
CONCLUSION: Based on these data, a simple algorithm is proposed to enhance medical decision-making in acute care indications useful primarily in hospitals not having readily available quantitative tests and 24/7. This algorithm not only determines DOAC exposure but also differentiates between factor Xa and thrombin inhibitors to better guide clinical management.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Thrombosis and haemostasis - (2024) vom: 08. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Harenberg, Job [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Revised 08.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1055/a-2261-1811 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
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| 100 | 1 | |a Harenberg, Job |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Algorithm for Rapid Exclusion of Clinically Relevant Plasma Levels of Direct Oral Anticoagulants in Patients Using the DOAC Dipstick |b An Expert Consensus Paper |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 08.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a Thieme. All rights reserved. | ||
| 520 | |a BACKGROUND: With the widespread use of direct oral anticoagulants (DOACs), there is an urgent need for a rapid assay to exclude clinically relevant plasma levels. Accurate and rapid determination of DOAC levels would guide medical decision-making to (1) determine the potential contribution of the DOAC to spontaneous or trauma-induced hemorrhage; (2) identify appropriate candidates for reversal, or (3) optimize the timing of urgent surgery or intervention | ||
| 520 | |a METHODS AND RESULTS: The DOAC Dipstick test uses a disposable strip to identify factor Xa- or thrombin inhibitors in a urine sample. Based on the results of a systematic literature search followed by an analysis of a simple pooling of five retrieved clinical studies, the test strip has a high sensitivity and an acceptably high negative predictive value when compared with levels measured with liquid chromatography tandem mass spectrometry or calibrated chromogenic assays to reliably exclude plasma DOAC concentrations ≥30 ng/mL | ||
| 520 | |a CONCLUSION: Based on these data, a simple algorithm is proposed to enhance medical decision-making in acute care indications useful primarily in hospitals not having readily available quantitative tests and 24/7. This algorithm not only determines DOAC exposure but also differentiates between factor Xa and thrombin inhibitors to better guide clinical management | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Gosselin, Robert C |e verfasserin |4 aut | |
| 700 | 1 | |a Cuker, Adam |e verfasserin |4 aut | |
| 700 | 1 | |a Becattini, Cecilia |e verfasserin |4 aut | |
| 700 | 1 | |a Pabinger, Ingrid |e verfasserin |4 aut | |
| 700 | 1 | |a Poli, Sven |e verfasserin |4 aut | |
| 700 | 1 | |a Weitz, Jeffrey |e verfasserin |4 aut | |
| 700 | 1 | |a Ageno, Walter |e verfasserin |4 aut | |
| 700 | 1 | |a Bauersachs, Rupert |e verfasserin |4 aut | |
| 700 | 1 | |a Celap, Ivana |e verfasserin |4 aut | |
| 700 | 1 | |a Choi, Philip |e verfasserin |4 aut | |
| 700 | 1 | |a Douketis, James |e verfasserin |4 aut | |
| 700 | 1 | |a Douxfils, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Elalamy, Ismail |e verfasserin |4 aut | |
| 700 | 1 | |a Falanga, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Fareed, Jawed |e verfasserin |4 aut | |
| 700 | 1 | |a Favaloro, Emmanuel J |e verfasserin |4 aut | |
| 700 | 1 | |a Gerotziafas, Grigorios |e verfasserin |4 aut | |
| 700 | 1 | |a Herkner, Harald |e verfasserin |4 aut | |
| 700 | 1 | |a Hetjens, Svetlana |e verfasserin |4 aut | |
| 700 | 1 | |a Heubner, Lars |e verfasserin |4 aut | |
| 700 | 1 | |a Klamroth, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Langer, Forian |e verfasserin |4 aut | |
| 700 | 1 | |a Lip, Gregory Y H |e verfasserin |4 aut | |
| 700 | 1 | |a Grory, Brian Mac |e verfasserin |4 aut | |
| 700 | 1 | |a Margetić, Sandra |e verfasserin |4 aut | |
| 700 | 1 | |a Merrelaar, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Pikta, Marika |e verfasserin |4 aut | |
| 700 | 1 | |a Renne, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Schulman, Sam |e verfasserin |4 aut | |
| 700 | 1 | |a Schwameis, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Strbian, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Tafur, Alfonso |e verfasserin |4 aut | |
| 700 | 1 | |a Vassart, Julie |e verfasserin |4 aut | |
| 700 | 1 | |a Violi, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Walenga, Jeanine |e verfasserin |4 aut | |
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