Interference of the new oral anticoagulant dabigatran with frequently used coagulation tests.
Author(s): Halbmayer WM, Weigel G, Quehenberger P, Tomasits J, Haushofer AC, Aspoeck G, Loacker L, Schnapka-Koepf M, Goebel G, Griesmacher A
Publication: Clin Chem Lab Med, 2012, Vol. 50, Page 1601-5
PubMed ID: 23100377 PubMed Review Paper? No
Purpose of Paper
Conclusion of Paper
Studies
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Study Purpose
The purpose of this study was to determine the effects of the oral anticoagulant dabigatran on routine coagulation assays using spiked plasma. Data was pooled from six hospitals which used different reagents and analyzers for each of the assays.
Summary of Findings:
The addition of dabigatran to plasma specimens led to dose dependent decreases in the percentage of PT activity, increases in APTT, and increases in AT activity via factor IIa. The authors report that results were highly variable between hospitals, likely due to the different reagents used. When fibrinogen assays were performed with reagents containing >50 units/mL thrombin, dabigatran had less effects, but reagents with a lower thrombin concentration yielded decreased fibrinogen concentration measurements when dabigatran levels were >0.24 ug/mL. Plasma specimens spiked with dabigatran also showed decreases in clotting factor activities and false positive diagnoses of lupus anticoagulant and APC-resistance. Thrombin-independent assays (von Willebrand-factor antigen, free Protein S, plasminogen, protein C, and AT via Xa) were generally less affected or were not affected by dabigatran.
Biospecimens
Preservative Types
- Other Preservative
Diagnoses:
- Normal
Platform:
Analyte Technology Platform Protein Hematology/ auto analyzer Glycoprotein Hematology/ auto analyzer Morphology Hematology/ auto analyzer Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Aliquots and Components Biospecimen components 0.00 ug/mL dabigatran
0.05 ug/mL dabigatran
0.10 ug/mL dabigatran
0.24 ug/mL dabigatran
0.48 ug/mL dabigatran
Hematology/ auto analyzer Specific Reaction solution <50 U/mL thrombin
>50 U/mL thrombin