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

Frackiewicz, Aleksandra; Kalaska, Bartlomiej; Miklosz, Joanna; Mogielnicki, Andrzej

doi:10.1186/s12959-023-00501-7

Table 2 Experimental 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

Method	Experimental procedure	Tests	Effectively removed anticoagulants
Method	Experimental procedure	Tests	Complete	Incomplete
Idarucizumab	Added in concentration of 125 µg/ml[86, 87] to normal plasma spiked with DOAC	aPTT	dabigatran[60, 81]
		PT	dabigatran[60, 81]
		TT	dabigatran [81]	dabigatran [60]
		dRVVT, aPTT-LA	dabigatran[60, 81]
		APC-R	dabigatran[60, 81]
		FVII, FVIII, FIX and FX assays	dabigatran[60, 81]
	Added in concentration of 125 µg/ml [87] to plasma samples from DOAC-treated patients*	TGA		dabigatran [82]*
Andexanet alfa	Added in concentration of 100 µg/ml [92], 200 µg/ml[93, 94] to plasma spiked with DOAC	ACT	betrixaban [87]	edoxaban [87]
		aPTT	rivaroxaban [87], edoxaban [87], betrixaban [87]	apixaban [87]
		PT	rivaroxaban [87], apixaban [87], edoxaban [87], betrixaban [87]
		PiCT		rivaroxaban [87], apixaban [87], edoxaban [87], betrixaban [87]
		Anti-FXa assay		rivaroxaban [87], apixaban [87], edoxaban [87], betrixaban [87]
		dRVVT, aPTT-LA		rivaroxaban [88]
		FVIII, FIX assays		rivaroxaban [89]
		CAT	rivaroxaban [87], apixaban [87], edoxaban [87], betrixaban [87]
Protamine sulfate	Added in concentration of 0-200 µg/ml [109, 117, 118] to normal plasma spiked with heparin or plasma samples from heparin-treated patients*	aPTT		UFH [101, 106]
		PT		UFH [106]
		TT	UFH [106]
		Anti-FXa assay	UFH [106]	UFH [109], LMWH [109]
		Anti-FIIa assay		UFH [109], LMWH [109]
		FVIII, FIX assays		UFH [106]
		TEG		UFH [110], LMWH [110]
Heparin-binding copolymer	Added in concentration of 10–50 µg/ml [15] to normal plasma spiked with heparin	aPTT	UFH [113]
		TT		UFH [13], LMWH [13]
		Anti-FXa assay	LMWH [114]	UFH [13], LMWH [16, 113]

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 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; DOAC, direct oral anticoagulant; dRVVT, dilute Russell Viper Venom time; LWMH, low-molecular-weight heparin; PiCT, prothrombinase-induced clotting time; PT, prothrombin time; TEG, thromboelastography; TGA, thrombin generation assay; TT, thrombin time; UFH, unfractionated heparin

Back to article page

ISSN: 1477-9560

Contact us

Submission enquiries: journalsubmissions@springernature.com

Thrombosis Journal

Contact us