Abstract
Worldwide, millions of patients are put on short-term and long-term anticoagulant therapy for several thrombotic indications. The critical balance of the inherent risk of bleeding and the anticoagulant effect of these drugs needs to be maintained. There is an increasing use of new oral anticoagulants apart from the conventional agents such as heparin and vitamin K antagonists, and it is imperative to know the appropriate assay(s) that are used for each drug monitoring. Hence, both clinical and laboratory personnel should be aware of assays to monitor different anticoagulant therapy and various physiological as well as laboratory variables affecting these results.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Peacock W, Rafique Z, Singer A. Direct-acting oral anticoagulants: practical considerations for emergency medicine physicians. Emer Med Int. 2016;2016:1–13.
Ruff C, Giugliano R, Braunwald E, Hoffman E, Deenadayalu N, Ezekowitz M, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomized trials. Lancet. 2014;383(9921):955–62.
Smythe MA, Priziola J, Dobesh PP, Wirth D, Cuker A, Wittkowsky AK. Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism. J Thromb Thrombolysis. 2016;41:165–86.
Baglin T, Barrowcliffe TW, Cohen A, et al. Guidelines on the use and monitoring of heparin. Br J Haematol. 2006;133(1):19–34.
Zehnder J, Prince E, Jin J. Controversies in heparin monitoring. Am J Hematol. 2012;87(Suppl 1):S137–40.
Bates SM, Weitz JI, Johnston M, Hirsh J, Ginsberg JS. Use of a fixed activated partial thromboplastin time ratio to establish a therapeutic range. Arch Int Med. 2001;161:385–91.
Vandiver JW, Vondracek TG. AntifactorXa levels versus activated partial thromboplastin time for monitoring unfractionated heparin. Pharmacotherapy. 2012;32:546–58.
Funk DM. Coagulation assays and anticoagulant monitoring. Hematology. 2012;2012:460–5.
Makris M, Van Veen J, Tait C, Mumford A, Laffan M. Guideline on the management of bleeding in patients on antithrombotic agents. Br J Haematol. 2012;160(1):35–46.
Hirsh J, Dalen JE, Anderson DR, et al. Oral anticoagulants: mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest. 2001;119(Suppl):8–21.
Breckenridge A, Orme M, Wesseling H, et al. Pharmacokinetics and pharmacodynamics of the enantiomers of warfarin in man. Clin Pharmacol Ther. 1974;15:424–30.
Favaloro EJ, Adcock DM. Standardization of the INR: how good is your laboratory’s INR and can it be improved? Semin Thromb Hemost. 2008;34(7):593–603.
Dorfman DM, Goonan EM, Boutilier MK, Jarolim P, Tanasijevic M, Goldhaber S. Point-of-care (POC) versus central laboratory instrumentation for monitoring oral anticoagulation. Vasc Med. 2005;10(1):23–7.
Lewis S, Bain B, Bates I, Dacie J, Dacie J. Dacie and Lewis practical haematology. Philadelphia: Churchill Livingstone; 2006.
Conway S, Hwang A, Ponte C, Gums J. Laboratory and clinical monitoring of direct-acting oral anticoagulants: what clinicians need to know. Pharmacotherapy. 2017;37(2):236–48.
Ten Cate H. New oral anticoagulants: discussion on monitoring and adherence should start now! Thromb J. 2013;11(1):8.
Ramos-Esquivel A. Monitoring anticoagulant therapy with new oral agents. World J Methodol. 2015;5(4):212.
Gous T, Couchman L, Patel J, Paradzai C, Arya R, Flanagan R. Measurement of the direct oral anticoagulants apixaban, dabigatran, edoxaban, and rivaroxaban in human plasma using turbulent flow liquid chromatography with high-resolution mass spectrometry. Ther Drug Monit. 2014;36(5):597–605.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Gupta, A., Udayakumar, D.S., Saxena, R. (2019). Laboratory Monitoring of Anticoagulant therapy. In: Saxena, R., Pati, H. (eds) Hematopathology. Springer, Singapore. https://doi.org/10.1007/978-981-13-7713-6_22
Download citation
DOI: https://doi.org/10.1007/978-981-13-7713-6_22
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-13-7712-9
Online ISBN: 978-981-13-7713-6
eBook Packages: MedicineMedicine (R0)