The effect of the direct factor Xa inhibitors apixaban and rivaroxaban on haemostasis tests: a comprehensive assessment using in vitro and ex vivo samples.

摘要: The direct oral anticoagulants (DOACs), now including dabigatran, apixaban and rivaroxaban, have given clinicians alternative options to low molecular weight heparins (LMWHs) vitamin K antagonist therapy, warfarin, for the treatment of atrial fibrillation prevention venous thromboembolic (VTE) disease. DOACs been successfully marketed as not requiring monitoring; however, there will be situations where request laboratory testing, emergency department admissions haemorrhage or thrombosis, surgical interventions. We report results several Royal College Pathologists Australasia Quality Assurance Programs (RCPAQAP) surveys using rivaroxaban spiked samples either assess suitability certain potential screening drug-quantifying assays, assessment drug presence absence measurement levels, well assessing interference in a wide variety haemostasis assays. also include additional evaluations ex vivo from patients various therapeutic reasons. prothrombin time (PT) activated partial thromboplastin (APTT) show better sensitivity with than apixaban. Anti-Xa assays good concordance reproducibility expected levels; availability these may limited larger institutions. Interference on testing extends beyond routine coagulation encompass plethora specialised factor lupus inhibitor, FVIII inhibitor estimation. In conclusion, this highlights influence drugs most tests performed laboratories, some predict presence, level plasma.