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Measurement of non-VKA oral anticoagulants versus classic ones: the appropriate use of hemostasis assays

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Douxfils, Jonathan [FUNDP] Tamigniau, Anne [UCL] Chatelain, Bernard [UCL] Goffinet, Catherine [UCL] Dogné, Jean-Michel [FUNDP] Mullier, François [UCL]

Traditional anticoagulant agents such as vitamin K antagonists (VKAs), unfractionated heparin (UFH), low molecular weight heparins (LMWHs) and fondaparinux have been widely used in the prevention and treatment of thromboembolic diseases. However, these agents are associated with limitations, such as the need for regular coagulation monitoring (VKAs and UFH) or a parenteral route of administration (UFH, LMWHs and fondaparinux). Several non-VKA oral anticoagulants (NOACs) are now widely used in the prevention and treatment of thromboembolic diseases and in stroke prevention in non-valvular atrial fibrillation. Unlike VKAs, NOACs exhibit predictable pharmacokinetics and pharmacodynamics. They are therefore usually given at fixed doses without routine coagulation monitoring. However, in certain patient populations or special clinical circumstances, measurement of drug exposure may be useful, such as in suspected overdose, in patients experiencing a hemorrhagic or thromboembolic event during the treatment's period, in those with acute renal failure, in patients who require urgent surgery or in case of an invasive procedure. This article aims at providing guidance on laboratory testing of classic anticoagulants and NOACs.

Document type Article de périodique (Journal article) – Synthèse de littérature
Access type Accès libre
Publication date 2014
Language Anglais
Journal information "Thrombosis Journal" - Vol. 12, no.1, p. 24 [1-18] (2014)
Peer reviewed yes
Publisher BioMed Central Ltd. ((United Kingdom) London)
e-issn 1477-9560
Publication status Publié
Affiliations UCL - SSS/IREC/MONT - Pôle Mont Godinne
UCL - (MGD) Laboratoire de biologie clinique
Keywords Apixaban ; Dabigatran ; Enoxaparin ; Low molecular weight heparin ; Monitoring ; Non-VKA oral anticoagulants ; Rivaroxaban ; Vitamin K antagonist
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Bibliographic reference Douxfils, Jonathan ; Tamigniau, Anne ; Chatelain, Bernard ; Goffinet, Catherine ; Dogné, Jean-Michel ; et. al. Measurement of non-VKA oral anticoagulants versus classic ones: the appropriate use of hemostasis assays. In: Thrombosis Journal, Vol. 12, no.1, p. 24 [1-18] (2014)
Permanent URL http://hdl.handle.net/2078.1/173416