ArticleClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
Evaluation of the DOAC-Stop Procedure by LC-MS/MS Assays for Determining the Residual Activity of Dabigatran, Rivaroxaban, and Apixaban.
Article in Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Rapid assessment of direct oral anticoagulants in acute stroke-An educational systematic review.European stroke journal · 2025Pooled it
- Usefulness and Limits of DOAC Removal Agents Based on Activated Charcoal in Thrombophilia Testing: Literature Review and Expert Proposals.Thrombosis and haemostasis · 2026Review
- Heparin Anticoagulant Therapy and Its Monitoring.Biomolecules · 2026Review
- Determining Thrombogenicity: Using a Modified Thrombin Generation Assay to Detect the Level of Thrombotic Event Risk in Lupus Anticoagulant-Positive Patients.Biomedicines · 2023Article
- The methods for removal of direct oral anticoagulants and heparins to improve the monitoring of hemostasis: a narrative literature review.Thrombosis journal · 2023Review
- Novel Ex Vivo DOAC Removal Methods Reduce Interference in Lupus Anticoagulant Testing.Diagnostics (Basel, Switzerland) · 2022Article
- Article
- Determination of Thrombogenicity Levels of Various Antiphospholipid Antibodies by a Modified Thrombin Generation Assay in Patients with Suspected Antiphospholipid Syndrome.International journal of molecular sciences · 2022Article
- Direct Oral Anticoagulant removal by a DOAC filter: Impact on lupus anticoagulant testing - Evaluation on spiked and patient samples.Research and practice in thrombosis and haemostasis · 2022Article
- Lupus anticoagulant testing during anticoagulation, including direct oral anticoagulants.Research and practice in thrombosis and haemostasis · 2022Review
- Evaluation of the Determination of Dabigatran, Rivaroxaban, and Apixaban in Lupus Anticoagulant-Positive Patients.Diagnostics (Basel, Switzerland) · 2021Article
- DOAC-Stop in lupus anticoagulant testing: Direct oral anticoagulant interference removed in most samples.Research and practice in thrombosis and haemostasis · 2021Article
- Escaping the catch 22 of lupus anticoagulant testing.RMD open · 2020Review
- Impact of Dabigatran Treatment on Rotation Thromboelastometry.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisObservational
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The effect of direct oral anticoagulants (DOACs) on laboratory tests dependent on the production of their targets, factor IIa and factor Xa (FXa), is a well-known problem and can cause both false positive and negative results. Therefore, the correct interpretation of tests performed in patients receiving DOACs is necessary to avoid misclassification and subsequent clinical consequences. However, even with significant experience, there are situations where it is not possible to assess the influence of some methods. Particularly important is the situation in the diagnosis of lupus anticoagulants using the dilute Russell viper venom timetest, which is based on direct FXa activation. A very promising solution to this situation is offered by the DOAC laboratory balancing procedure DOAC-Stop. For evaluating the effectiveness of this procedure, 60 (20 apixaban, 20 dabigatran, and 20 rivaroxaban) patients treated with DOACs were enrolled. All patient samples were analyzed for the presence of individual DOAC types and subsequently subjected to the DOAC-Stop procedure.We evaluated its effectiveness by our own high-performance liquid chromatography-coupled tandem mass spectrometrymethod, which simultaneously sets all high-sensitivity DOACs. Unlike coagulation tests based on the determination of the residual effects of DOACs on target enzymes, which is complicated by extensive interindividual variation, this methodology is highly specific and sensitive.The DOAC-Stop procedure eliminated dabigatran from 99.5%, rivaroxaban from 97.9%, and apixaban from 97.1% of participants in our group. Residual amounts did not exceed 2.7 ng/mL for dabigatran, 10.9 ng/mL for rivaroxaban, or 13.03 ng/mL for apixaban, which are safe values that do not affect either screening or special coagulation tests.
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