Change search
ReferencesLink to record
Permanent link

Direct link
Effects of the oral, direct thrombin inhibitor dabigatran on five common coagulation assays
Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
Sahlgrens University Hospital.
University of Gothenburg.
Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry.
Show others and affiliations
2011 (English)In: THROMBOSIS AND HAEMOSTASIS, ISSN 0340-6245, Vol. 105, no 2, 371-378 p.Article in journal (Refereed) Published
Abstract [en]

Dabigatran is an oral, reversible thrombin inhibitor that has shown promising results in large clinical trials. Laboratory monitoring is not needed but the effects on common coagulation assays are incompletely known. Dabigatran was added to plasma from healthy subjects in the concentration range 0-1,000 mu g/l and analysed using several reagents for activated thromboplastin time (APTT), prothrombin time (PT), fibrinogen, antithrombin, and activated protein C resistance. Typical trough concentrations are about 50 mu g/l, peak concentrations 100-300 mu g/l. At 100 mu g/l all APTT-results were prolonged. The concentration required to double APTT ranged between 227 and 286 mu g/l, the responses for all five reagents were similar. PT-reagents were much less affected with almost no samples above INR 1.2 at 100 mu g/l. The effect was sample dilution dependent with PT Quick type more sensitive than PT Owren type methods. If a patient on dabigatran has prolonged APTT, andgt; 90 seconds, and Quick PT INR andgt; 2 or Owren PT INR andgt; 1.5 over-dosing or accumulation of dabigatran should be considered. Two of four fibrinogen reagents underestimated the fibrinogen concentration considerably at expected peak concentration. Methods based on inhibition of thrombin over-estimated the antithrombin concentration, but not Xa-based. The APC-resistance methods over-estimated the APC-ratio, which may lead to miss-classification of factory Leiden patients as being normal. Different coagulation assays, and even different reagents within an assay group, display variable effects at therapeutic concentrations of dabigatran. Some of these assay variations are of clinical importance, thus knowledge is needed for a correct interpretation of results.

Place, publisher, year, edition, pages
F K Schattauer Verlagsgesellschaft MBH , 2011. Vol. 105, no 2, 371-378 p.
Keyword [en]
Dabigatran, thrombin inhibitor, interference, anticoagulant, coagulation assays
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-66845DOI: 10.1160/TH10-06-0342ISI: 000287943600023OAI: diva2:405521
This article is not an exact copy of the original published article in THROMBOSIS AND HAEMOSTASIS. The definitive publisher-authenticated version is available:: Tomas Lindahl, Fariba Baghaei, Inger Fagerberg Blixter, Kerstin Gustafsson, Lennart Stigendal, Margareta Sten-Linder, Karin Strandberg and Andreas Hillarp, Effects of the oral, direct thrombin inhibitor dabigatran on five common coagulation assays, 2011, THROMBOSIS AND HAEMOSTASIS, (105), 2, 371-378. from: 2011-03-22 Created: 2011-03-21 Last updated: 2012-03-25

Open Access in DiVA

fulltext(371 kB)2858 downloads
File information
File name FULLTEXT01.pdfFile size 371 kBChecksum SHA-512
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Search in DiVA

By author/editor
Lindahl, TomasGustafsson, Kerstin
By organisation
Clinical ChemistryFaculty of Health SciencesDepartment of Clinical Chemistry
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 2858 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 1963 hits
ReferencesLink to record
Permanent link

Direct link