Observational studyCritical care (London, England)2017
Point-of-care testing for emergency assessment of coagulation in patients treated with direct oral anticoagulants.
Observational study in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Point-of-Care Testing of Coagulation in Patients Treated With Direct Oral Anticoagulants 2
Qualitative Coagulation Testing With the CoaguChek(R) Pro II Point-of-Care Test System and aPTT Test Cards in Patients Before and After First Intake of Direct Oral Anticoagulants
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- Rapid assessment of direct oral anticoagulants in acute stroke-An educational systematic review.European stroke journal · 2025Pooled it
- Optimal management of cardiac surgery patients using direct oral anticoagulants: recommendations for clinical practice.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2023Pooled it
- A scoping review of factors affecting activated clotting time measurement results.Thrombosis journal · 2026Review
- Feasibility of Direct Oral Anticoagulant Dipstick Point-of-Care Testing in Patients with Acute Stroke and Transient Ischaemic Attack.Cerebrovascular diseases extra · 2026Article
- Thirteen serum biochemical indexes and five whole blood coagulation indices in a point-of-care testing analyzer: ideal protocol for evaluating pulmonary and critical care medicine.Journal of Zhejiang University. Science. B · 2025Article
- Pharmacokinetics of Apixaban Among Peritoneal Dialysis Patients.Kidney medicine · 2023Article
- Direct oral anticoagulants or vitamin K antagonists in emergencies: comparison of management in an observational study.Research and practice in thrombosis and haemostasis · 2023Article
- Electrochemical Disposable Biosensor to Monitor Dabigatran in Point-of-Care Anticoagulation Therapy.Molecules (Basel, Switzerland) · 2023Article
- Current and future strategies to monitor and manage coagulation in ECMO patients.Thrombosis journal · 2023Review
- Urine-based point-of-care testing for factor-Xa-inhibitors in acute ischemic stroke patients: a feasibility study.Frontiers in neurology · 2023Article
- Diagnostic Modalities in Critical Care: Point-of-Care Approach.Diagnostics (Basel, Switzerland) · 2021Review
- Intra-procedural anticoagulation and post-procedural hemoglobin fall in atrial fibrillation ablation with minimally interrupted direct oral anticoagulants: comparisons across 4 drugs.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2021Article
- Specific Point-of-Care Testing of Coagulation in Patients Treated with Dabigatran.Thrombosis and haemostasis · 2021Article
- Recanalisation therapies for acute ischaemic stroke in patients on direct oral anticoagulants.Journal of neurology, neurosurgery, and psychiatry · 2021Review
- Point-of-care testing for emergency assessment of coagulation in patients treated with direct oral anticoagulants including edoxaban.Neurological research and practice · 2021Article
- Coagulation and heparin requirements during ablation in patients under oral anticoagulant drugs.Journal of arrhythmia · 2020Article
- A New Test for the Detection of Direct Oral Anticoagulants (Rivaroxaban and Apixaban) in the Emergency Room Setting.Critical care explorations · 2019Article
- Article
- Rationale and design of the Registry of Acute Stroke Under Novel Oral Anticoagulants-prime (RASUNOA-prime).European stroke journal · 2019Article
- Patients on NOACs in the Emergency Room.Current neurology and neuroscience reports · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPoint-of-care testing (POCT) of coagulation has been proven to be of great value in accelerating emergency treatment. Specific POCT for direct oral anticoagulants (DOAC) is not available, but the effects of DOAC on established POCT have been described. We aimed to determine the diagnostic accuracy of Hemochron® Signature coagulation POCT to qualitatively rule out relevant concentrations of apixaban, rivaroxaban, and dabigatran in real-life patients.
methodsWe enrolled 68 patients receiving apixaban, rivaroxaban, or dabigatran and obtained blood samples at six pre-specified time points. Coagulation testing was performed using prothrombin time/international normalized ratio (PT/INR), activated partial thromboplastin time (aPTT), and activated clotting time (ACT+ and ACT-low range) POCT cards. For comparison, laboratory-based assays of diluted thrombin time (Hemoclot) and anti-Xa activity were conducted. DOAC concentrations were determined by liquid chromatography-tandem mass spectrometry.
resultsFour hundred and three samples were collected. POCT results of PT/INR and ACT+ correlated with both rivaroxaban and dabigatran concentrations. Insufficient correlation was found for apixaban. Rivaroxaban concentrations at <30 and <100 ng/mL were detected with >95% specificity at PT/INR POCT ≤1.0 and ≤1.1 and ACT+ POCT ≤120 and ≤130 s. Dabigatran concentrations at <30 and <50 ng/mL were detected with >95% specificity at PT/INR POCT ≤1.1 and ≤1.2 and ACT+ POCT ≤100 s.
conclusionsHemochron® Signature POCT can be a fast and reliable alternative for guiding emergency treatment during rivaroxaban and dabigatran therapy. It allows the rapid identification of a relevant fraction of patients that can be treated immediately without the need to await the results of much slower laboratory-based coagulation tests.
trial registrationUnique identifier, NCT02371070 . Retrospectively registered on 18 February 2015.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.