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Quick Question: Pradaxa Measurement

Glen Holloway asks if it was possible to add “in-house dilute thrombin time” to the current Quick Question list. George promised to update this in July, and will finally keep his promise. The current Quick Question was:

The new oral anticoagulants are being used more and more. How do you plan to measure dabigatran (Pradaxa) levels?

a. Stago’s ecarin clotting time: 1 (2%)
b. Stago’s ECA (ecarin chromogenic assay): 10 (20%)
c. Standard prothrombin time without INR: 2 (4%)
d. Standard thrombin time: 13 (26%)
e. HEMOCLOT’s plasma-diluted thrombin time: 24 (48%)

It looks like the plasma-diluted thrombin time has the early lead. The prothrombin time was a mislead, as the PT is relatively insensitive to dabigatran, and the partial thromboplastin time (PTT) provides a somewhat more linear, albeit unstable result. The standard thrombin time may be used to rule in or rule out dabigatran, as it is super sensitive. Watch for a reprise on this QQ with updates related to Glen Holloway’s request.

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