Format

Send to

Choose Destination
Thromb J. 2014 Nov 4;12:24. doi: 10.1186/1477-9560-12-24. eCollection 2014.

Measurement of non-VKA oral anticoagulants versus classic ones: the appropriate use of hemostasis assays.

Author information

1
Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium.
2
Hematology Laboratory, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for LIfe Sciences (NARILIS), CHU Dinant Godinne UcL Namur, Université Catholique de Louvain, 1, avenue Dr Gaston Therasse, B5530 Yvoir, Belgium.
3
Clinique et Maternité Sainte-Elisabeth, Namur, Belgium.
4
Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for LIfe Sciences (NARILIS), University of Namur, Namur, Belgium ; Hematology Laboratory, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for LIfe Sciences (NARILIS), CHU Dinant Godinne UcL Namur, Université Catholique de Louvain, 1, avenue Dr Gaston Therasse, B5530 Yvoir, Belgium.

Abstract

Traditional anticoagulant agents such as vitamin K antagonists (VKAs), unfractionated heparin (UFH), low molecular weight heparins (LMWHs) and fondaparinux have been widely used in the prevention and treatment of thromboembolic diseases. However, these agents are associated with limitations, such as the need for regular coagulation monitoring (VKAs and UFH) or a parenteral route of administration (UFH, LMWHs and fondaparinux). Several non-VKA oral anticoagulants (NOACs) are now widely used in the prevention and treatment of thromboembolic diseases and in stroke prevention in non-valvular atrial fibrillation. Unlike VKAs, NOACs exhibit predictable pharmacokinetics and pharmacodynamics. They are therefore usually given at fixed doses without routine coagulation monitoring. However, in certain patient populations or special clinical circumstances, measurement of drug exposure may be useful, such as in suspected overdose, in patients experiencing a hemorrhagic or thromboembolic event during the treatment's period, in those with acute renal failure, in patients who require urgent surgery or in case of an invasive procedure. This article aims at providing guidance on laboratory testing of classic anticoagulants and NOACs.

KEYWORDS:

Apixaban; Dabigatran; Enoxaparin; Low molecular weight heparin; Monitoring; Non-VKA oral anticoagulants; Rivaroxaban; Vitamin K antagonist

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center