ArticleNeurological research and practice2021
Point-of-care testing for emergency assessment of coagulation in patients treated with direct oral anticoagulants including edoxaban.
Article in Neurological research and practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02825394 (Specific Point-of-Care Testing of Coagulation in Patients Treated With Direct Oral Anticoagulants Part 1), which is not on this map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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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.
Specific Point-of-Care Testing of Coagulation in Patients Treated With Direct Oral Anticoagulants Part 1
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Rapid assessment of direct oral anticoagulants in acute stroke-An educational systematic review.European stroke journal · 2025Pooled it
- Evaluation of Direct Oral Anticoagulant Reversal Agents in Intracranial Hemorrhage: A Systematic Review and Meta-analysis.JAMA network open · 2022Pooled it
- A scoping review of factors affecting activated clotting time measurement results.Thrombosis journal · 2026Review
- Coagulation assays for assessing the bypassing of factor Xa direct oral anticoagulants using VMX-C001.Research and practice in thrombosis and haemostasis · 2026Article
- Feasibility of Direct Oral Anticoagulant Dipstick Point-of-Care Testing in Patients with Acute Stroke and Transient Ischaemic Attack.Cerebrovascular diseases extra · 2026Article
- Recent intake of direct oral anticoagulants and acute ischemic stroke: real world data from a comprehensive stroke center.Neurological research and practice · 2025Article
- Thromboembolic prevention in athletes: management of anticoagulation in sports players affected by atrial fibrillation.Frontiers in pharmacology · 2024Review
- 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
- Point-of-Care Assessment of Direct Oral Anticoagulation in Acute Ischemic Stroke: Protocol for a Prospective Observational Diagnostic Accuracy Study.Thrombosis and haemostasis · 2022Article
- Intravenous Thrombolysis With Alteplase at 0.6 mg/kg in Patients With Ischemic Stroke Taking Direct Oral Anticoagulants.Journal of the American Heart Association · 2022Observational
- Intravenous thrombolysis in patients taking direct oral anticoagulants (ESO IVT guidelines comment).European stroke journal · 2021Article
- Coagulopathies in Intensive Care Medicine: Balancing Act between Thrombosis and Bleeding.Journal of clinical medicine · 2021Review
- Detection of Direct Oral Anticoagulants in Patient Urine Samples by Prototype and Commercial Test Strips for DOACs - A Systematic Review and Meta-analysis.TH open : companion journal to thrombosis and haemostasis · 2021Article
- Decision-Making Process for the Management of Acute Stroke in Patients on Oral Anticoagulant: From Guidelines to Clinical Routine.Frontiers in neurology · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundDirect oral anticoagulants (DOAC) including edoxaban are increasingly used for stroke prevention in atrial fibrillation. Despite treatment, annual stroke rate in these patients remains 1-2%. Rapid assessment of coagulation would be useful to guide thrombolysis or reversal therapy in this growing population of DOAC/edoxaban-treated stroke patients. Employing the Hemochron™ Signature Elite point-of-care test system (HC-POCT), clinically relevant plasma concentrations of dabigatran and rivaroxaban can be excluded in a blood sample. However, no data exists on the effect of edoxaban on HC-POCT results. We evaluated whether edoxaban plasma concentrations above the current treatment thresholds for thrombolysis or anticoagulation reversal (i.e., 30 and 50 ng/mL) can be ruled out with the HC-POCT.
methodsWe prospectively studied patients receiving a first dose of edoxaban. Six blood samples were collected from each patient: before, 0.5, 1, 2, 8, and 24 h after drug intake. HC-POCT-based INR (HC-INR), activated clotting time (HC-ACT+ and HC-ACT-LR), activated partial thromboplastin time (HC-aPTT), and mass spectrometry for edoxaban plasma concentrations were performed at each time-point. We calculated correlations, receiver operating characteristics (ROC) and test-specific cut-offs for ruling out edoxaban concentrations > 30 and > 50 ng/mL in a blood sample.
resultsOne hundred twenty blood samples from 20 edoxaban-treated patients were analyzed. Edoxaban plasma concentrations ranged from 0 to 512 ng/mL. HC-INR/HC-ACT+/HC-ACT-LR/HC-aPTT ranged from 0.7-8.3/78-310 s/65-215 s/19-93 s, and Pearson's correlation coefficients showed moderate to very strong correlations with edoxaban concentrations (r = 0.95/0.79/0.70/0.60). With areas under the ROC curve of 0.997 (95% confidence interval: 0.991-0.971) and 0.989 (0.975-1.000), HC-INR most reliably ruled out edoxaban concentrations > 30 and > 50 ng/mL, respectively, and HC-INR results ≤1.5 and ≤ 2.1 provided specificity/sensitivity of 98.6% (91.2-99.9)/98.0% (88.0-99.9) and 96.8% (88.0-99.4)/96.5% (86.8-99.4).
conclusionsOur study represents the first systematic evaluation of the HC-POCT in edoxaban-treated patients. Applying sufficiently low assay-specific cut-offs, the HC-POCT may not only be used to reliably rule out dabigatran and rivaroxaban, but also very low edoxaban concentrations in a blood sample. Because the assay-specific cut-offs were retrospectively defined, further investigation is warranted.
trial registrationClinicalTrials.gov, registration number: NCT02825394 , registered on: 07/07/2016, URL.
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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.