Abstract
Monitoring coagulation is recommended only in specific situation, especially if standardised tests are available, which serves multiple purposes such as efficacy, assess bleeding, use of antidotes, and aid in drug selection. Coagulation assays may provide qualitative or quantitative assessment of the drug used. Laboratory measurements are dependent on several patient factors such as age, time when the last dose was taken, half-life and other factors affecting pharmacokinetics for the appropriate interpretation of the test results. Clinical monitoring along with noncoagulation laboratory monitoring also play a major role in many patient scenarios. This chapter gives information on the physiology, pharmacology and monitoring of anticoagulation.
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References
Gage BF, Birman-Deych E, Kerzner R, Radford MJ, Nilasena DS, Rich MW. Incidence of intracranial hemorrhage in patients with atrial fibrillation who are prone to fall. Am J Med. 2005;118(6):612–7.
Conway SE, Hwang AY, Ponte CD, Gums JG. Laboratory and clinical monitoring of direct acting oral anticoagulants: what clinicians need to know. Pharmacotherapy. 2017;37(2):236–48.
Beshay JE, Morgan H, Madden C, Wengui Y, Sarode R. Emergency reversal of anticoagulation and antiplatelet therapies in neurosurgical patients. J Neurosurg. 2010;112:307–18.
Oranmore-Brown C, Griffiths R. Anticoagulants and the perioperative period. Continuing education in anaesthesia. Crit Care Pain. 2006;6(4):156–9.
Roskell NS, Lip GY, Noack H, Clemens A, Plumb JM. Treatments for stroke prevention in atrial fibrillation: A network meta-analysis and indirect comparisons versus dabigatran etexilate. Thromb Haemost. 2010;104:1106–15.
Shamoun F, Obeid H, Ramakrishna H. Novel anticoagulants in atrial fibrillation: monitoring, reversal and perioperative management. BioMed Res Int 2015; Article ID 424031, 8 pages.
Orme R, Judge HM, Storey RF. Monitoring antiplatelet therapy. Semin Thromb Hemost. 2017;43:311–9.
Janssen PW, ten Berg JM. Platelet function testing and tailored antiplatelet therapy. J Cardiovasc Transl Res. 2013;6:316–28.
Gross L, Aradi D, Sibbing D. Platelet function testing in patients on antiplatelet medications. Semin Thromb Hemost. 2016;42:306–20.
Hvas AM, Grove EL. Platelet function tests: Preanalytical variables, clinical utility, advantages, and disadvantages. Methods Mol Biol. 2017;1646:305–20.
Chlebowski MM, Baltagi S, Carlson M, Levy JH, Spinella PC. Clinical controversies in anticoagulation monitoring and antithrombin supplementation for ECMO. Crit Care. 2020;24:19.
Dubois V, Dincq A-S, Douxfils J, Ick B, Samama C-M, Dogné J-M, et al. Perioperative management of patients on direct oral anticoagulants. Thromb J. 2017;15:14.
Douketis JD, Wang G, Chan N, Eikelboom JW, Syed S, Barty R, Moffat KA, Spencer FA, Blostein M, Schulman S. Effect of standardized perioperative dabigatran interruption on the residual anticoagulation effect at the time of surgery or procedure. J Thromb Haemost. 2016;14:89–97.
Stangier J, Feuring M. Using the HEMOCLOT direct thrombin inhibitor assay to determine plasma concentrations of dabigatran. Blood Coagul Fibrinolysis. 2012;23:138–43.
Lassen MR, Gallus A, Raskob GE, Pineo G, Chen D, Ramirez LM. Investigators A-: Apixaban versus enoxaparin for thromboprophylaxis after hip replacement. N Engl J Med. 2010;363:2487–98.
Douxfils J, Ageno W, Samama C-M, Lessire S, ten Cate H, Verhamme P, Dogne J-M, Mullier F. Laboratory testing in patients treated with direct oral anticoagulants: a practical guide for clinicians. J Thromb Haemost. 2018;16:209–19.
Stangier J, Rathgen K, Stähle H, Gansser D, Roth W. The pharmacokinetics, pharmacodynamics and tolerability of dabigatran etexilate, a new oral direct thrombin inhibitor, in healthy male subjects. Br J Clin Pharmacol. 2007;64:292–303.
Lassen MR, Raskob GE, Gallus A, Pineo G, Chen D, Hornick P, investigators A. Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomised double-blind trial. Lancet. 2010;375:807–15.
Prexl O, Bruckbauer M, Voelckel W, Grottke O, Ponschab M, Maegele M, et al. The impact of direct oral anticoagulants in traumatic brain injury patients greater than 60-years-old. Scand J Trauma Resusc Emerg Med. 2018;26:20.
Vos PE, Alekseenko Y, Battistin L, Ehler E, Gerstenbrand F, Muresanu DF, et al. Mild traumatic brain injury. Eur J Neurol. 2012;19:191–8.
Samama MM, Contant G, Spiro TE, Perzborn E, Guinet C, Gourmelin Y, et al. Evaluation of the anti-factor Xa chromogenic assay for the measurement of rivaroxaban plasma concentrations using calibrators and controls. Thromb Haemost. 2012;107:379–87.
Wiegele M, Schöchl H, Haushofer A, Ortler M, Leitgeb J, Kwasny O, et al. Diagnostic and therapeutic approach in adult patients with traumatic brain injury receiving oral anticoagulant therapy: an Austrian interdisciplinary consensus statement. Crit Care. 2019;23:62.
Connors JM. Testing and monitoring direct oral anticoagulants. Blood. 2018;132(19):2009–15.
Anderson DR, Morgano GP, Bennett C, Dentali F, Francis CW, Garcia DA, et al. American Society of Hematology 2019 guidelines for management of venous thromboembolism: prevention of venous thromboembolism in surgical hospitalized patients. Blood Adv. 2019;3(23)
Steiner T, Bohm M, Dichgans M, Diener HC, Ell C, Endres M, et al. Recommendations for the emergency management of complications associated with the new direct oral anticoagulants (DOACs), apixaban, dabigatran and rivaroxaban. Clin Res Cardiol. 2013;102:399–412.
Seiffge DJ, Traenka C, Polymeris AA, Thilemann S, Wagner B, Hert L, et al. Intravenous thrombolysis in patients with stroke taking rivaroxaban using drug specific plasma levels: experience with a standard operation procedure in clinical practice. J Stroke. 2017;19:347–55.
Fox KA, Mehta SR, Peters R, Zhao F, Lakkis N, Gersh BJ, Yusuf S, et al. Benefits and risks of the combination of clopidogrel and aspirin in patients undergoing surgical revascularization for non-ST-elevation acute coronary syndrome: the Clopidogrel in unstable angina to prevent recurrent ischemic events (CURE) trial. Circulation. 2004;110(10):1202–8.
Steinhubl TR, Berger PB, Tift Mann J, Fry ETA, DeLago A, Wilmer C, Topol EJ et al. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA. 2002 20;288(19):2411–20.
Eikelboom JW, Wallentin L, Connolly SJ, et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant therapy (RE-LY) trial. Circulation. 2011;123(21):2363–72.
Fox KAA, Piccini JP, Wojdyla D, et al. Prevention of stroke and systemic embolism with rivaroxaban compared with warfarin in patients with non-valvular atrial fibrillation and moderate renal impairment. Eur Heart J. 2011;32(19):2387–94.
Rosenstein R, Parra D. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365(24):2334.
Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92.
Giugliano RP, Ruff CT, Braunwald E, Murphy SA, Wiviott SD, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369:2093–104.
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Jayaram, K. (2022). Monitoring Anticoagulation. In: Prabhakar, H., S Tandon, M., Kapoor, I., Mahajan, C. (eds) Transfusion Practice in Clinical Neurosciences. Springer, Singapore. https://doi.org/10.1007/978-981-19-0954-2_38
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