SynthesisFrontiers in cardiovascular medicine2022
The impact of direct oral anticoagulants on viscoelastic testing - A systematic review.
Synthesis in Frontiers in cardiovascular medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 41 citations in OpenAlex.
- Excessive Apixaban Concentrations in a Bleeding Patient Treated With Pharmacological Reversal and Extracorporal Removal-A Case Report.Pharmacology research & perspectives · 2026Article
- Measuring Direct Oral Anticoagulant (DOAC) Levels: Applications, Limitations, and Future Directions.International journal of laboratory hematology · 2026Review
- Biomarkers of Coagulation Disorders-Where to from Here?Biomolecules · 2026Review
- Viscoelastic Point-of-Care Testing (ClotProNeurology international · 2025Article
- [Overdosing of direct oral anticoagulants].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- [Point of care coagulation diagnostics-Absolutely necessary or only a reasonable supplement?]Die Anaesthesiologie · 2025Review
- Ischemic Stroke in Patients Under Oral Anticoagulation: The Achilles Heel of Atrial Fibrillation Management.Brain sciences · 2025Review
- Validation of a whole blood coagulometer sensitive to the direct oral anticoagulants.Scientific reports · 2025Article
- Viscoelastic monitoring of direct oral anticoagulants (DOAC).Blood transfusion = Trasfusione del sangue · 2025Article
- Edoxaban Overdose in a Child: Unexpected Observation of Clot Lysis.TH open : companion journal to thrombosis and haemostasis · 2025Article
- Systematic Scoping on Point-of-care Monitoring of Direct Oral Anticoagulants in Patients with Non-valvular Atrial Fibrillation: Current Status and Future Perspectives in Malaysia.European cardiology · 2025Review
- Management of severe traumatic brain injury in a rivaroxaban overdose: illustrative case.Journal of neurosurgery. Case lessons · 2024Article
- Should viscoelastic testing be a standard point-of-care test on all intensive care units?Journal of the Intensive Care Society · 2024Review
- The Role of Viscoelastic Testing in Assessing Hemostasis: A Challenge to Standard Laboratory Assays?Journal of clinical medicine · 2024Review
- Management of patients with proximal femur fractures under DOACs.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Review
- [Update on point-of-care-based coagulation treatment : Systems, reagents, device-specific treatment algorithms].Die Anaesthesiologie · 2024Review
- Antithrombotic and prohemorrhagic actions of different concentrations of apixaban in patients exposed to single and dual antiplatelet regimens.Scientific reports · 2023Article
- Challenges to Laboratory Monitoring of Direct Oral Anticoagulants.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisReview
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In case of bleeding patients and in acute care, the assessment of residual direct oral anticoagulant (DOAC) activity is essential for evaluating the potential impact on hemostasis, especially when a timely decision on urgent surgery or intervention is required. Viscoelastic tests are crucial in a modern goal-directed coagulation management to assess patients' coagulation status. However, the role of viscoelastic test to detect and quantify residual DOAC plasma levels is controversially discussed. The aim of this review was to systematically summarize the evidence of viscoelastic tests for the assessment of residual DOAC activity. Method: PubMed, Embase, Scopus, and the Cochrane Library were searched for original articles investigating the effect of rivaroxaban, apixaban, edoxaban, or dabigatran plasma levels on different viscoelastic tests of the adult population from database inception to December 31, 2021. Results: We included 53 studies from which 31 assessed rivaroxaban, 22 apixaban, six edoxaban, and 29 dabigatran. The performance of viscoelastic tests varied across DOACs and assays. DOAC specific assays are more sensitive than unspecific assays. The plasma concentration of rivaroxaban and dabigatran correlates strongly with the ROTEM EXTEM, ClotPro RVV-test or ECA-test clotting time (CT) and TEG 6s anti-factor Xa (AFXa) or direct thrombin inhibitor (DTI) channel reaction time (R). Results of clotting time (CT) and reaction time (R) within the normal range do not reliable exclude relevant residual DOAC plasma levels limiting the clinical utility of viscoelastic assays in this context. Conclusion: Viscoelastic test assays can provide fast and essential point-of-care information regarding DOAC activity, especially DOAC specific assays. The identification and quantification of residual DOAC plasma concentration with DOAC unspecific viscoelastic assays are not sensitive enough, compared to recommended anti-Xa activity laboratory measurements. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=320629], identifier [CRD42022320629].
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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.