Blood Spotlight The laboratory and the direct oral anticoagulants
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چکیده
The direct oral anticoagulants (DOAC), which include the thrombin inhibitor dabigatran and the anti-Xa agents rivaroxaban, apixaban, and edoxaban, are in clinical use in many countries (Figure 1). Clinical trials have shown that DOAC, unlike vitamin K antagonists (VKA), are effective and safe when administered without dose adjustment based on laboratory testing. However, it is a misconception to believe that the laboratory will not have a role in the management of patients treated with DOAC. This review is aimed at discussing:
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The laboratory and the direct oral anticoagulants.
Although direct oral anticoagulants do not need laboratory testing for dose adjustment, there are instances when laboratory measurement of the drug anticoagulant effect may be useful. They include before initiation of treatment, before surgical or invasive procedures, on the occasion of hemorrhagic or thrombotic events, and whenever immediate reversal of anticoagulation is needed. Choice of tes...
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Direct oral anticoagulants targeting specific coagulation factors have been introduced as alternatives to conventional anticoagulants for both prophylactic and therapeutic indications. They have succeeded in overcoming the limitations of vitamin K antagonists. Although the favourable efficacy and side-effect profiles compared to vitamin K antagonists is proven, there is significant concern abou...
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تاریخ انتشار 2013