BACKGROUND: The utility of measuring non-vitamin K antagonist oral anticoagulants (NOACs) in plasma, serum and urine samples and with the point-of-care test (POCT) on urine samples should be analysed in an international laboratory study. METHODS: The study was performed to determine the inter-laboratory variance of data from two chromogenic assays each for the NOACs rivaroxaban, apixaban and dabigatran, and to analyse the sensitivity and specificity of the POCT assays for factor Xa- and thrombin inhibitors. Plasma, serum and urine samples were taken from six patients in each group on treatment with a NOAC. RESULTS: The inter-laboratory variances, which can be identified best by the coefficient of variation, ranged from 46% to 59% for apixaban, 63% to 73% for rivaroxaban and 39% to 104% for dabigatran using plasma, serum or urine samples and two chromogenic assays for each NOAC. The concentrations were about 20% higher in serum compared to plasma samples for apixaban and rivaroxaban, and 60% lower for dabigatran. The concentration in urine samples was five-fold (apixaban), 15-fold (rivaroxaban) and 50-fold (dabigatran) higher. Sensitivity and specificity of POCT for apixaban, rivaroxaban, and dabigatran were all >94%. CONCLUSIONS: The inter-laboratory study showed the feasibility of measurement of apixaban, rivaroxaban, and dabigatran in plasma, serum and urine samples of patients on treatment. Dabigatran was determined at far lower levels in serum compared to plasma samples. Concentrations of NOACs in urine were much higher compared to plasma. The POCT was highly sensitive and specific for all three NOACs.
BACKGROUND: The utility of measuring non-vitamin K antagonist oral anticoagulants (NOACs) in plasma, serum and urine samples and with the point-of-care test (POCT) on urine samples should be analysed in an international laboratory study. METHODS: The study was performed to determine the inter-laboratory variance of data from two chromogenic assays each for the NOACsrivaroxaban, apixaban and dabigatran, and to analyse the sensitivity and specificity of the POCT assays for factor Xa- and thrombin inhibitors. Plasma, serum and urine samples were taken from six patients in each group on treatment with a NOAC. RESULTS: The inter-laboratory variances, which can be identified best by the coefficient of variation, ranged from 46% to 59% for apixaban, 63% to 73% for rivaroxaban and 39% to 104% for dabigatran using plasma, serum or urine samples and two chromogenic assays for each NOAC. The concentrations were about 20% higher in serum compared to plasma samples for apixaban and rivaroxaban, and 60% lower for dabigatran. The concentration in urine samples was five-fold (apixaban), 15-fold (rivaroxaban) and 50-fold (dabigatran) higher. Sensitivity and specificity of POCT for apixaban, rivaroxaban, and dabigatran were all >94%. CONCLUSIONS: The inter-laboratory study showed the feasibility of measurement of apixaban, rivaroxaban, and dabigatran in plasma, serum and urine samples of patients on treatment. Dabigatran was determined at far lower levels in serum compared to plasma samples. Concentrations of NOACs in urine were much higher compared to plasma. The POCT was highly sensitive and specific for all three NOACs.
Authors: Priscilla Bento Matos Derogis; Livia Rentas Sanches; Valdir Fernandes de Aranda; Marjorie Paris Colombini; Cristóvão Luis Pitangueira Mangueira; Marcelo Katz; Adriana Caschera Leme Faulhaber; Claudio Ernesto Albers Mendes; Carlos Eduardo Dos Santos Ferreira; Carolina Nunes França; João Carlos de Campos Guerra Journal: PLoS One Date: 2017-02-07 Impact factor: 3.240
Authors: V Serrano-Sánchez; J Ripollés-de Ramón; L Collado-Yurrita; I Vaello-Checa; C Colmenero-Ruiz; A Helm; M-J Ciudad-Cabañas; V Serrano-Cuenca Journal: Med Oral Patol Oral Cir Bucal Date: 2017-09-01
Authors: Gerald A Soff; Jodi Mones; Cy Wilkins; Sean Devlin; Eva Haegler-Laube; Jonathan Wills; Debra M Sarasohn; Krishna Juluru; Michael Singer; Yimei Miao; Jeanette Batista; Simon Mantha Journal: Res Pract Thromb Haemost Date: 2019-05-24
Authors: Rachel Aakerøy; Charlotte L Stokes; Marija Tomić; Solfrid Hegstad; Ann Helen Kristoffersen; Hanne Ellekjær; Jan Schjøtt; Olav Spigset; Arne Helland Journal: Ther Drug Monit Date: 2022-01-20 Impact factor: 3.118
Authors: Debnath Maji; Aman Opneja; Michael A Suster; Kara L Bane; Brigid M Wilson; Pedram Mohseni; Evi X Stavrou Journal: Thromb Haemost Date: 2020-09-02 Impact factor: 5.249