Measurement of dabigatran in standardly used clinical assays, whole blood viscoelastic coagulation, and thrombin generation assays

Clin Lab Med. 2014 Sep;34(3):479-501. doi: 10.1016/j.cll.2014.06.008. Epub 2014 Jul 22.

Abstract

Dabigatran, a direct thrombin inhibitor, is increasingly used clinically as one of the new oral anticoagulants. This review summarizes the assays available to measure its activity and includes the relative sensitivity of the different assays for this agent. In addition to plasma-based clotting tests, assays commonly used in surgical/emergency settings, such as activated clotting time and thromboelastometry/thromboelastography, are reviewed. In addition, the thrombin generation assay is discussed as an important method to determine the potential risk of thrombosis or bleeding and its relevance to the measurement of direct thrombin inhibitors.

Keywords: Anticoagulation; Dabigatran; Measurement; Thrombin generation; Thromboelastometry.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Administration, Oral
  • Animals
  • Antithrombins / administration & dosage
  • Antithrombins / blood*
  • Antithrombins / pharmacokinetics
  • Antithrombins / therapeutic use
  • Benzimidazoles / administration & dosage
  • Benzimidazoles / blood*
  • Benzimidazoles / pharmacokinetics
  • Benzimidazoles / therapeutic use
  • Blood Coagulation / drug effects*
  • Blood Coagulation Tests
  • Dabigatran
  • Drug Monitoring / methods*
  • Humans
  • Precision Medicine*
  • beta-Alanine / administration & dosage
  • beta-Alanine / analogs & derivatives*
  • beta-Alanine / blood
  • beta-Alanine / pharmacokinetics
  • beta-Alanine / therapeutic use

Substances

  • Antithrombins
  • Benzimidazoles
  • beta-Alanine
  • Dabigatran