Why the study?
Do point-of-care coagulation tests accurately detect DOAC-induced coagulopathy and guide reversal therapy in patients receiving DOACs?
Do point-of-care coagulation tests accurately detect DOAC-induced coagulopathy and guide reversal therapy in patients receiving DOACs?
Point-of-care coagulation tests are useful for detecting dabigatran-induced coagulopathy and guiding its reversal, but they lack accuracy for monitoring apixaban and rivaroxaban.
Point-of-care tests may detect DOAC effects in emergencies; hypothesis-generating and requires prospective validation before adoption.
Direct oral anticoagulants (DOACs) exert similar anticoagulant effects to vitamin K antagonists and are increasingly used worldwide. Nevertheless, an evidence-based approach to patients receiving DOACs when any unplanned urgent surgery or bleeding (either spontaneous or traumatic) occurs is still missing. In this review, we investigate the role of point-of-care coagulation tests when other, more specific tests are not available. Indeed, thromboelastography and activated clotting time can detect dabigatran-induced coagulopathy, while their accuracy is limited for apixaban and rivaroxaban, mostly in cases of low drug plasma concentrations. These tests can also be used to guide the reversal of DOAC-induced coagulopathy providing a quick, before-and-after picture in case of therapeutic use of hemostatic compounds.
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Bianchi et al. (2017) studied this question.
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