Skip to main content

Table 1 Commercially available methods for removal of anticoagulants in diagnostic tests

From: The methods for removal of direct oral anticoagulants and heparins to improve the monitoring of hemostasis: a narrative literature review

DOACs

Method

Experimental procedure

Tests

Removal of anticoagulants

Complete

Incomplete

DOAC-Stop

1 tablet for 1 ml of normal plasma spiked with DOAC or plasma samples from DOAC-treated patients*

aPTT

dabigatran[60, 63], rivaroxaban [63], apixaban [63], edoxaban [63]

rivaroxaban [65]*, apixaban [65]*

PT

dabigatran[60, 63], rivaroxaban [63], apixaban [63], edoxaban [63]

rivaroxaban [65]*, apixaban [65]*

TT

 

dabigatran [60]

fibrinogen

dabigatran [60]

 

FVIII assay

dabigatran [60], rivaroxaban [89]

 

FVII assay

dabigatran [60]

 

FX assay

dabigatran [60], rivaroxaban [89]

 

dRVVT

dabigatran [36]*, [60], rivaroxaban [36]*, apixaban [36]*, edoxaban [36]*

rivaroxaban [65]*, apixaban [65]*

aPTT-LA

dabigatran [36]*, [60], [66]*, rivaroxaban [36]*, [66]*, apixaban [36]*, edoxaban [36]*

apixaban [66]*

APC-R

dabigatran [36]*, [60], apixaban [36]*, edoxaban [36]*

rivaroxaban [36]*

Protein C

 

dabigatran [36]*, rivaroxaban [36]*, apixaban [36]*, edoxaban [36]*

Protein S

 

dabigatran [36]*, rivaroxaban [36]*, apixaban [36]*, edoxaban [36]*

Antithrombin activity

 

dabigatran [36]*, rivaroxaban [36]*, apixaban [36]*, edoxaban [36]*

CAT

rivaroxaban [63], apixaban [63], edoxaban [63]

dabigatran [63]

TEG

 

dabigatran [63], rivaroxaban [63], apixaban [63], edoxaban [63]

HPLC-MS/MS

 

dabigatran [67]*, rivaroxaban [67]*, apixaban [67]*

DOAC-Remove

1 tablet for 1 ml of normal plasma spiked with DOAC or plasma samples from DOAC-treated patients*

dTT

dabigatran [61]*, [62]*

 

Anti-FXa assay

rivaroxaban [61]*, apixaban [61]*, edoxaban [61]*

rivaroxaban [62]*, apixaban [62]*

dRVVT

 

dabigatran [62]*, rivaroxaban [62]*, apixaban [61]*, [62]*, edoxaban [61]*

APC-R

 

dabigatran [35]*, rivaroxaban [35]*, apixaban [35]*

HPLC-MS/MS

 

dabigatran [62]*, rivaroxaban [62]*, apixaban [62]*

DOAC Filter

600 µl of normal plasma spiked with DOAC or plasma samples from DOAC-treated patients* loaded in the cartridge

aPTT

dabigatran [71], rivaroxaban [71]

apixaban [71]

PT

dabigatran [71], rivaroxaban [71]

apixaban [71]

dTT

dabigatran [72]

 

ECA

dabigatran [69]

 

Anti-FXa assay

rivaroxaban[69, 72], apixaban [69], edoxaban[69, 72]

rivaroxaban [70]*, apixaban [70]*, [72]

SCT

 

rivaroxaban [70]*, apixaban [70]*

dRVVT

 

rivaroxaban [70]*, apixaban [70]*

HPLC-MS/MS

rivaroxaban [70]*, apixaban [70]*

 

Heparins

Heparinase

Added in the concentration of 2 IU[16, 99]/4 IU [99] to normal plasma spiked with heparin or plasma samples from heparin-treated patients*

aPTT

UFH [14]*, [59]*, LMWH [14]*

UFH [94]*

PT

 

UFH [14]*, [94]*, LMWH [14]*

TT

LMWH [14]*

UFH [14]*

Anti-FXa assay

UFH [59]*

 

TGA

 

UFH [11], LMWH [11]

Heparinized plasma samples added to heparinase I-coated plastic cuvettes

TEG

UFH [96], LMWH [96]

 

Polybrene

Added in concentration of 0-100 µg/ml [13, 15, 97, 108,109,110] to normal plasma spiked with heparin or plasma samples from heparin-treated patients*

aPTT

UFH [101, 102]

UFH [100]

PT

 

UFH [100]

TT

UFH [102]

UFH [13], LMWH [13]

ACT

UFH [92]*

 

Anti-FXa assay

 

UFH [13], LMWH [13]

dRVVT

UFH [102]

 

TGA

UFH [11], LMWH [11]

 
  1. If anticoagulant removal was 100% or as defined by the authors, it was marked “complete”; if anticoagulant removal did not reach 100% or as defined by the authors, it was marked “incomplete”. References are given in parentheses. References with asterisk describe the effect of samples from DOAC or heparin treated patients. ACT, activated clotting time; APC-R, activated protein C resistance; aPTT, activated partial thromboplastin time; aPTT-LA, lupus anticoagulant sensitive activated partial thromboplastin time; CAT, calibrated automated thrombography; DOACs, direct oral anticoagulants; dRVVT, dilute Russell Viper Venom time; dTT, diluted thrombin time; ECA, ecarin chromogenic assay; HPLC-MS/MS, high-performance liquid chromatography-coupled tandem mass spectrometry; LWMH, low-molecular-weight heparin; PT, prothrombin time; SCT, silica clotting time; TEG, thromboelastography; TGA, thrombin generation assay; TT, thrombin time; UFH, unfractionated heparin