Key result
Urine DOAC dipstick identifies clinically relevant anticoagulation with 100% sensitivity using automated readout.
Why the study?
Rapid assessment of direct oral anticoagulant activity is essential in acute ischemic stroke to guide intravenous thrombolysis decisions, but laboratory assays have limited availability and slow turnaround.
Does urine-based point-of-care DOAC dipstick testing accurately detect clinically relevant DOAC activity compared to plasma assays in acute ischemic stroke patients?
Population
101 consecutive acute ischemic stroke patients including 55 with DOAC intake
Comparison
Urine-based point-of-care dipstick test vs calibrated plasma DOAC levels
Design
Prospective diagnostic accuracy study
Authors
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Urine-based point-of-care DOAC dipstick testing provides a rapid and highly sensitive method for detecting clinically relevant DOAC activity in acute ischemic stroke patients, potentially accelerating thrombolysis decision-making.
Observational (n=101)
Blinded
No
Does urine-based point-of-care DOAC dipstick testing accurately detect clinically relevant DOAC activity compared to plasma assays in acute ischemic stroke patients?
Effect estimate: Sensitivity 100%, Specificity 96.3% (95% CI 92.4%-100%)
Absolute Event Rate: 100% vs 96.3%
Urine-based point-of-care DOAC dipstick testing provides a rapid and highly sensitive method for detecting clinically relevant DOAC activity in acute ischemic stroke patients, potentially accelerating thrombolysis decision-making.
Gerner et al. (2025) conducted an observational in Acute ischemic stroke (n=101). Urine-based point-of-care DOAC dipstick vs. Calibrated plasma DOAC levels was evaluated on Sensitivity of the urine-based dipstick test for detecting specific DOAC levels ≥ 30 ng/mL (Sensitivity 100%, Specificity 96.3%, 95% CI 92.4%-100%). The urine-based DOAC dipstick reliably identified relevant anticoagulatory activity (anti-Xa ≥30 ng/mL) with a sensitivity of 100% and specificity of 96.3% using an automated readout.