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Table 2 In detail: NOAC sensitivity of different global coagulation tests in plasma

From: Global assays and the management of oral anticoagulation

   Rivaroxaban Apixaban Dabigatran
   In vivo therapeutic dose1
  Acute VTE: 15 mg bid 10 mg bid 150 mg bid
Prophylaxis: 20 mg od 5 mg bid 150 mg bid
   In vivo mean plasma concentration (Cmin-Cmax, μg/L)1
  Acute VTE: 100 - 270 104 - 330 93 - 184
Prophylaxis: 45 - 250 50 - 128 93 - 184
   In vitro effective concentration (μg/L)2
PT – Innovin 399 ± 49 >800 596 ± 73
– Thromborel 392 ± 36 >800 554 ± 41
– Neoplastin 214 ± 36 >800 538 ± 47
modified PT – mPT-Innovin 43 ± 3 190 ± 13 64 ± 6
– mPT-Thromborel 47 ± 3 80 ± 6 88 ± 10
APTT – Actin FSL 254 ± 28 >800 190 ± 15
TGA – Lag time 41 ± 5 93 ± 28 27 ± 7
– Peak thrombin 109 ± 5 121 ± 4 380 ± 71
– AUC 151 ± 36 327 ± 99 433 ± 71
TEG-TF – R 28 ± 3 80 ± 17 16 ± 8
– Angle 263 ± 66 721 ± 73 484 ± 3
– MA >800 >800 >800
  1. 1NOAC dose (od, once daily; bid, twice daily) currently advised for the treatment of acute venous thromboembolism (VTE) and the prophylactic treatment of VTE and atrial fibrillation [81,82] with mean NOAC concentration in plasma at steady state during treatment pre dose (Cmin) and 2 h post dose (Cmax) [83-85].
  2. 2Pooled normal citrated plasma was spiked with NOACs ranging from 0–800 μg/L plasma and subjected to PT APTT, TGA and TEG analysis. The modified PT (mPT) reagent consisted of a mixture of 1 volume thromboplastin reagent and 1.25 volumes 80 mM CaCl2 [85]. The TGA assay was with 5 pM TF and 4 μM phospholipids. The TEG-TF in plasma was with 10 pM TF and 4 μM phospholipids. Effective concentration (EC±50%) was defined as a 50% increase or decrease in assay parameter by the NOAC of interest as compared to incubations without NOAC. EC±50% values were obtained by interpolation and are given as mean ± SD of at least 3 determinations with the same plasma pool. Part of the data were taken from Dinkelaar et al. and detailed methods can be found in that study [32].