Thrombosis and Hemostasis Center, University of California, Davis Health System, Sacramento, CA 95817, USA.
Department of Medicine and Department of Pathology & Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Clin Lab Med. 2024 Sep;44(3):551-562. doi: 10.1016/j.cll.2024.04.014. Epub 2024 May 30.
Direct oral anticoagulants (DOACs) have significant advantages over vitamin K antagonists including lack of need for routine laboratory monitoring. However, assessment of DOAC effect and concentration may be important to guide clinical management including need for DOAC reversal, particularly in acute or emergent situations. In this manuscript, the authors describe tests to screen for DOAC presence and tests that have demonstrated equivalence to gold standard testing for quantifying DOAC exposure. They also discuss the effect of DOACs on other coagulation assays and strategies for monitoring unfractionated heparin in patients with concomitant DOAC exposure.
直接口服抗凝剂（DOAC）相对于维生素 K 拮抗剂具有显著优势，包括无需常规实验室监测。然而，评估 DOAC 的效果和浓度对于指导临床管理可能很重要，包括是否需要逆转 DOAC，尤其是在急性或紧急情况下。在本文中，作者描述了用于筛查 DOAC 存在的检测方法和已证明等效于金标准检测 DOAC 暴露量的检测方法。他们还讨论了 DOAC 对其他凝血检测的影响以及监测同时使用 DOAC 患者的未分级肝素的策略。
