Monitoring of Anticoagulant Activity of Dabigatran and Rivaroxaban in the Presence of Heparins

Journal of Clinical Medicine

Shin-Ichi Yusa¹  Andrzej Mogielnicki²  Aleksandra Jakimczuk²  Bartlomiej Kalaska²  Dariusz Pawlak²  Joanna Miklosz²  Krzysztof Szczubiałka³  Kamil Kamiński³ 

[1] Department of Applied Chemistry, Graduate School of Engineering, University of Hyogo, Himeji 671-2280, Japan;Department of Pharmacodynamics, Medical University of Bialystok, 15-089 Bialystok, Poland;Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387 Krakow, Poland;

关键词: anticoagulants;    blood coagulation tests;    dabigatran;    heparin;    laboratory monitoring;    rivaroxaban;   

DOI  :  10.3390/jcm11082236

来源: DOAJ

【 摘 要 】

The routine monitoring of direct oral anticoagulants (DOACs) may be considered in patients with renal impairment, patients who are heavily obese, or patients requiring elective surgery. Using the heparin-binding copolymer (HBC) and polybrene, we aimed to develop a solution for monitoring the anticoagulant activity of DOACs in human plasma in the interfering presence of unfractionated heparin (UFH) and enoxaparin. The thrombin time (TT) and anti-factor Xa activity were monitored in pooled plasma from healthy volunteers. In these tests, plasma with dabigatran or rivaroxaban was mixed with UFH or enoxaparin and then incubated with HBC or polybrene, respectively. HBC and polybrene neutralized heparins and enabled monitoring of anticoagulant activity of dabigatran in the TT test. Both agents allowed for accurate measurement of anti-factor Xa activity in the plasma containing rivaroxaban and heparins in the concentration range reached in patients’ blood. Here, we present diagnostic tools that may improve the control of anticoagulation by eliminating the contamination of blood samples with heparins and enabling the monitoring of DOACs’ activity.

【 授权许可】

Unknown