Neurológia pre prax 3/2014

Monitoring of the efficacy of novel oral anticoagulants

Clinical situations that require monitoring of novel oral anticoagulants (NOAC) are: presence of bleeding, renal impairment, suspicion of overdose or in case of ischemic stroke an indication of thrombolytic therapy. Conventional coagulation assays as aPTT, TT or PT may not be sufficient for NOAC monitoring. Clinicians deciding about thrombolysis have to understand the interpretation of measured values, which can be different in patients taking dabigatran, rivaroxaban or apixaban. In addition, for NOAC, new specific tests are used, for example Hemoclot or standardized Anti-Xa tests and it is again essential to correctly interpret the measured results. This article provides an overview of suitable coagulation assays for particular NOAC and summarizes in tables available data about interpretation of measured results to give immediate information for a clinician for example about the possibility of using thrombolytic therapy.

Keywords: dabigatran, rivaroxaban, apixaban, NOAC, monitoring.