Wiener Medizinische Wochenschrift

, Volume 161, Issue 3–4, pp 58–62 | Cite as

Monitoring of direct anticoagulants

Themenschwerpunkt

Summary

In recent years, new anticoagulants directly targeting individual components of the coagulation cascade have been developed. Although there is no need for routine coagulation monitoring with most of these agents, there are several clinical situations where a specific coagulation test should be available. Global coagulation tests react very sensitive to direct thrombin inhibitors or factor Xa inhibitors. However, with most agents, the effects on activated partial thromboplastin time (APTT) and prothrombin time (PT) are not linear and heterogeneous with respect to different reagents. In contrast, chromogenic assays show a good correlation to the pharmacokinetic of a specific agent.

Keywords

Direct anticoagulants Monitoring Global coagulation tests Pharmacokinetics POCT 

Monitoring der direkten Antikoagulanzien

Zusammenfassung

In den vergangenen Jahren sind eine Reihe neuer Antikoagulanzien, die direkt einzelne, aktivierte Gerinnungsfaktoren der Gerinnungskaskade hemmen, entwickelt worden. Obgleich bei vielen dieser Substanzen keine Notwendigkeit der routinemäßigen Überwachung der Gerinnung besteht, gibt es verschiedene klinische Situationen, in denen ein spezifischer Gerinnungstest verfügbar sein sollte. Die globalen Gerinnungstests reagieren empfindlich auf die direkten Thrombin- bzw. Faktor Xa-Inhibitoren. Allerdings sind die Effekte auf die aktivierte partiale Thromboplastinzeit (APTT) and Prothrombinzeit (PT) nicht linear und in Bezug auf verschiedene Reagenzien heterogen. Demgegenüber zeigen Assays mit chromogenen Substraten eine gute Korrelation zur Pharmakokinetik einer spezifischen Substanz.

Schlüsselwörter

Direkte Antikoagulanzien Monitoring Globale Gerinnungstest Pharmakokinetik POCT 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Hemostasis and Transfusion MedicineLudwig-Maximilians-University of MunichMunichGermany
  2. 2.Department of AnaesthesiologyLudwig-Maximilians-University of MunichMunichGermany

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