Point-of-Care Testing of Coagulation in Patients Treated With Non–Vitamin K Antagonist Oral Anticoagulants

• DOI: 10.1161/strokeaha.115.010148
• Publication Date: 2015-08-14T03:29:31Z
• Authors: Matthias Ebner; Andreas Peter; Charlotte Spencer; Florian Härtig; Ingvild Birschmann; Joachim Kuhn; Martin Wolf; Natalie Winter; Francesca Russo; Christine S. Zuern; Gunnar Blumenstock; Ulf Ziemann; Sven Poli
• Keywords: Apixaban; Point-of-Care Testing; Coagulation testing; Vitamin K antagonist; Prothrombin time; Point of care; Activated clotting time

Specific coagulation assays for non-vitamin K antagonist oral anticoagulants (NOAC) are relatively slow and often lack availability. Although specific point-of-care tests (POCT) currently not available, NOAC known to affect established POCT. This study aimed at determining the diagnostic accuracy of CoaguChek POCT rule out relevant concentrations rivaroxaban, apixaban, dabigatran in real-life patients.We consecutively enrolled 60 ischemic stroke patients newly started on treatment obtained blood samples 6 prespecified time points. Samples were tested using POCT, laboratory-based (prothrombin activated partial thromboplastin time, anti-Xa test Hemoclot), liquid chromatography-tandem mass spectrometry direct determination concentrations.Three hundred fifty-six collected. The strongly correlated (r=0.82 P<0.001) with rivaroxaban but did accurately detect or apixaban. If used estimate presence low concentrations, was superior predictions based normal prothrombin values even if sensitive reagents used. POCT-results≤1.0 predicted concentrations<32 <100 ng/mL a specificity 90% 96%, respectively.If is we propose use guide thrombolysis decisions after individual risk assessment rivaroxaban-treated having acute stroke.URL: http://www.clinicaltrials.gov. Unique identifier: NCT02371044.