Table 1.
At a glance: global assay response to anticoagulation treatment
| Assay | Parameter | Oral anticoagulant | |||
|---|---|---|---|---|---|
| VKA | Apixaban | Rivaroxaban | Dabigatran | ||
| PT-Quick | Clotting time | ↑ | − | ↑ | ↑ |
| PT-Owren | Clotting time | ↑ | − | ↑ | ↑ |
| APTT | Clotting time | ↑ | − | ↑ | ↑ |
| TGA-TF | Lag time | ↑ | ↑ | ↑ | ↑ |
| Peak | ↓ | ↓ | ↓ | ↓ | |
| AUC | ↓ | ↓ | ↓ | ↓ | |
| TEG/TEM-TF | R/CT | ↑ | ↑/− | ↑ | ↑ |
| K/CFT | ↑ | − | − | − | |
| MA/MCF | ↓ | − | − | − | |
| TEG/TEM-CA* | R/CT | ↑/− | ↑/− | ↑ | ↑ |
| K/CFT | − | − | − | − | |
| MA/MCF | − | − | − | ↓/− | |
Qualitative comparison of the effect of NOACs on global testing parameters. PT, APTT and TGA assays were performed in citrated plasma. TEG/TEM assays were performed in citrated whole blood. Assay parameter is significantly increased (↑) or decreased (↓) by the oral anticoagulant, or effect is marginal to unnoticed (−). Classifications are based on the following publications: VKA [55-59], apixaban [32,35,60-63], rivaroxaban [62-69], dabigatran [32,56,63,69-74]. *Contact activator kaolin or celite. Global assays are sensitive to oral anticoagulation by VKAs, direct factor Xa inhibitors and direct thrombin inhibitors. Global coagulation assays, in general, do not show specificity to a particular drug. They are only different in drug sensitivity (see Table 2).