Table 11.
Plasma levels and coagulation assays in patients treated with NOACs for stroke prevention in AF
| Dabigatran97,548,549 | Apixaban550 | Edoxaban98,100 | Rivaroxaban519,520,551 | |
|---|---|---|---|---|
| Expected plasma levels of NOACs in patients treated for AF* | ||||
| Peak levels | 52–383 | 69–321 | 101–288 | 178–343 |
| Trough levels | 28–215 | 34–230 | 12–43 | 12–137 |
| Expected impact of NOACs on routine coagulation tests148,150,158,549,552–554 | ||||
| PT | (↑) peak (↑) if supratherapeutic149 |
(↑) at peak |
↑ at therapeutic levels (if sensitive assay is used) Normal values do not exclude trough levels |
↑ at therapeutic levels (if sensitive assay is used) Normal values do not exclude trough levels |
| aPTT |
↑↑(↑) Normal values exclude supratherapeutic- but not therapeutic levels |
(↑) at peak | (↑) at peak | (↑) at peak |
| ACT |
↑(↑) Consistent with effect on aPTT |
(↑) | (↑) | (↑) |
| TT |
↑↑↑↑ Normal values exclude presence of Dabigatran |
– | – | – |
ACT, activated clotting time; AF, atrial fibrillation; aPTT, activated prothrombin time; NOAC, non-vitamin K antagonist oral anticoagulant; PT, prothrombin time.
*
[ng/ml] 5–95% percentiles for FXa inhibitors and 10–90% percentiles (ng/ml) for Dabigatran).