Table 2: Effect of Direct Oral Anticoagulants on Haemostasis Tests and Drug Concentration Quantification[36,37].
NOAC | Quantification | PT | aPTT | TT |
---|---|---|---|---|
Dabigatran | Dilute TT (DTI assay), ECT, chromogenic anti-IIa assay | Variable depending on reagent | If normal, excludes supratherapeutic concentration | If normal, excludes clinically-relevant concentration |
Rivaroxaban | Anti-Xa concentration (calibrated for rivaroxaban) | If normal, excludes supratherapeutic concentration; can be used for crude estimation | Less sensitive than PT | Insensitive |
Apixaban | Anti-Xa concentration (calibrated for apixaban) | Insensitive; might have normal PT, despite therapeutic concentration | Insensitive; might have normal aPTT, despite therapeutic concentration | Insensitive |
Edoxaban | Anti-Xa concentration (calibrated for edoxaban) | If normal, excludes clinically-relevant concentration | If normal, excludes clinically-relevant concentration | Insensitive |
aPTT = activated partial thromboplastin time; DTI = direct thrombin inhibitor; ECT = ecarin clotting time; NOAC = new/novel oral anticoagulant; PT = prothrombin time; TT = thrombin time.