Anticoagulant Therapy

In Vitro DOAC Removal Agents

Wenxiong He [“Wen”], Toronto, Canada, is a participant in the Rutgers University graduate course CLSC 5124, Advanced Hemostasis. Wen is in the hematology lab at St. Michael’s Hospital in Toronto which includes the special coagulation lab. Wen offered this information about the use of a DOAC removal agent: “Our lab uses a DOAC removal product […]

Anticoagulant Therapy

Anti-Xa Dilution

Marietta Tomlin asks, Can Owren-Koller buffer be used instead of normal plasma to dilute anti-Xa when the are results above linearity? And if not, can you provide information on the reasoning/mechanisms as to why not? From LaShanta Brice, DCLS, MLS (ASCP)cmSH (ASCP)cm Scientific Engagement & Clinical Education Associate, Diagnostica Stago, Inc. Because our assay uses […]

Anticoagulant Therapy

Mixing Studies and Various Therapeutics

From Leslie Chaparro: We recently had a patient who had a mixing study ordered but who had recently taken tranexamic acid [TXA]. We exclude patients that have been on anticoagulants but have never really considered drugs that encourage clotting. How would this affect the patient’s mixing study? How do we keep up with all the […]

Anticoagulant Therapy

Precision BioLogic Poster at ISTH: DOAC-Remove

You are invited to visit the ISTH poster submitted by Precision BioLogic Inc.: PB1147 Effect of high-dose direct anticoagulant drugs and DOAC-Remove on lupus anticoagulant detection by a hexagonal phase phospholipid assay. The poster goes up Tuesday, 27 June 2023, 18:30–19:30.

Specimen Management

May 2023 Quick Question: DTI

Our May 2023 Quick Question asks, “Which DOAC is a direct thrombin inhibitor? Our 70 respondents chose… Dabigatran [Pradaxa]: 56 [80%] Rivaroxaban [Xarelto]: 3 [4%] Apixaban [Eliquis]: 3 [4%] Warfarin [Coumadin]: 7 [10%] Clopidogrel [Plavix]: [2%] Dabigatran is the direct thrombin inhibitor, whereas rivaroxaban and apixaban are direct anti-Xa inhibitors. Clopidogrel is an antiplatelet antithrombotic. […]

Quick Question Archive

May 2023 Quick Question: DOACs

Our May 2023 Quick Question asks “Which DOAC is a direct thrombin inhibitor?” Please select your answer. If you would like to add a comment, please click Comments below.

Anticoagulant Therapy

Discrepant PT and INR Results

From Soha Abuelela. I’m using the ACL Pro Elite for PT and PTT testing in my lab using Hemosil Recombiplastin 2G reagent but I frequently notice sample results showing normal PT time in seconds with normal concentration but the INR is above the reference interval! Could you please help me with possible causes and your […]

Anticoagulant Therapy

March 2023 Quick Question: Apixaban Reversal

Our March 2023 Quick Question asked, “Which reversal agent is effective in managing apixaban overdose?” Our 45 respondents chose: rFVIIa [NovoSeven]: 4 [9%] Andexanet alfa: 28 [62%] Idarucizumab: 5 [11%] Vitamin K: 6 [13%] FFP: 2 [5%] Before direct reversal agents became available, DOAC overdose-related bleeding was treated by attempting to absorb undigested anticoagulant from […]

Anticoagulant Therapy

Dabigatran Recall

Thanks to Dave McGlasson for forwarding this Medscape bulletin [click] announcing Ascend Laboratories’ recall of 10 dabigatran lots due to the detection of the nitrosamine impurity, N-nitroso-dabigatran, a potential carcinogen.

Anticoagulant Therapy

Mixed DOACs and the DOAC Clotting Time Test

In a January 2023 letter to the editor, available from the publisher or your library as Exner T, Ellwood L, Dangol M, Favaloro EJ. Mixing factor Xa and thrombin inhibiting direct oral anticoagulants produces a synergistic prolonging effect on most clotting tests. Int J Lab Hematol. 2023 Feb 21. doi: 10.1111/ijlh.14043, investigators examined a DRVVT-based […]

Anticoagulant Therapy

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George Fritsma is a medical laboratory scientist, educator, and author. George holds faculty appointments with Rutgers University and Michigan State University, and is a member of the International Society on Thrombosis and Hemostasis, American Association of Clinical Chemists, and American Society for Clinical Laboratory Science.

Cheat Sheets from George

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