Key result
Conventional coagulation tests fail to monitor NOACs due to alternative mechanisms versus VKAs and UFH.
Routine coagulation tests used for VKAs and UFH cannot be used to monitor NOACs due to their different modes of action.
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Clinicians should avoid conventional tests for NOAC monitoring; leaves open validation of specific assays.
Since the non-vitamin K antagonist oral anticoagulants (NOACs) have been introduced to clinical practice, there is a conflict on coagulation tests, which have been used to monitor the anticoagulation effect of vitamin K antagonists (VKAs) and unfractionated heparin (UFH). NOACs have alternative modes of action. They react differently than VKAs and UFH and therefore conventional coagulation tests are not suitable to monitor their anticoagulant effect. The interactions between NOACs and routine coagulation tests are discussed in this review.
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Ebru Türkoğlu (2015) conducted a review in Anticoagulation monitoring. Non-vitamin K antagonist oral anticoagulants (NOACs) vs. Vitamin K antagonists (VKAs) and unfractionated heparin (UFH) was evaluated on Interactions with routine coagulation tests. Conventional coagulation tests are not suitable to monitor the anticoagulant effect of NOACs due to their alternative modes of action compared to VKAs and UFH.
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