Division of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" Monaldi Hospital, Naples, Italy.
Department of Cardiology, Monaldi Hospital, Naples, Italy.
Semin Thromb Hemost. 2021 Mar;47(2):150-160. doi: 10.1055/s-0041-1723770. Epub 2021 Feb 26.
Measurement of direct oral anticoagulants (DOACs) activity is not routinely necessary. Indeed, evaluation of DOACs plasmatic concentration is discouraged for the majority of patients, due to the lack of outcome data supporting this approach. Nevertheless, DOAC measurements may be useful in emergency situations such as serious bleeding events, need for urgent invasive procedures, and acute ischemic stroke or in managing anticoagulation in "special populations" not adequately studied in clinical trials, for example the very elderly or those at the extremes of body weight. The aim of this review is to describe and summarize the methods for DOACs activity evaluation and the settings in which their plasma level measurement may be indicated, analyzing indications from scientific societies and evidence from clinical trials, as well as real world data on the usefulness of DOACs plasma levels "monitoring."
测定直接口服抗凝剂（DOACs）的活性通常并非必需。事实上，由于缺乏支持这种方法的结果数据，大多数患者不建议评估 DOACs 的血浆浓度。然而，在紧急情况下，如严重出血事件、需要紧急侵入性操作以及急性缺血性卒中等情况下，或者在临床试验中未充分研究的“特殊人群”中进行抗凝管理时，测定 DOACs 可能是有用的，例如非常高龄或体重处于极值的患者。本综述的目的是描述和总结 DOACs 活性评估的方法以及可能需要测量其血浆水平的情况，分析来自科学协会的适应证和临床试验的证据，以及 DOACs 血浆水平“监测”的实际用途的真实世界数据。
