Current insights into the possible role of laboratory monitoring of effectiveness and safety of direct oral anticoagulants
The article is devoted to the discussion of modern approaches to the use of laboratory methods to improve the tactics of using direct oral anticoagulants (DOACs) therapy. Clinical situations in which it may be reasonable to use data on the blood concentration of DOACs are given, including very old a...
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| Language: | English |
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Столичная издательская компания
2023-07-01
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| Series: | Рациональная фармакотерапия в кардиологии |
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| Online Access: | https://www.rpcardio.online/jour/article/view/2922 |
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| author | S. R. Gilyarevsky N. K. Vereina M. V. Golshmid |
| author_facet | S. R. Gilyarevsky N. K. Vereina M. V. Golshmid |
| author_sort | S. R. Gilyarevsky |
| collection | DOAJ |
| description | The article is devoted to the discussion of modern approaches to the use of laboratory methods to improve the tactics of using direct oral anticoagulants (DOACs) therapy. Clinical situations in which it may be reasonable to use data on the blood concentration of DOACs are given, including very old age, a marked deviation from the norm of body weight or impaired renal function. Data on the role of measuring the blood level of DOACs are considered in cases of the development of diseases or complications in which information is required on the preservation of the anticoagulant effect of DOACs, for example, in the development of severe bleeding or the need for urgent surgical intervention. The advantages and limitations of modern laboratory methods for assessing the blood concentration of DOACs are discussed. It is emphasized that one of the main advantages of using DOACs is the absence of the need to monitor laboratory parameters in most patients. Data from pharmacological studies are presented that may be useful in explaining the mechanisms that determine the higher safety of some DOACs compared to others. Promising methods for assessing the blood level of DOACs, as well as the possibility of using less specific reagents for assessing the concentration of DOACs, are considered. The possibility of using less specific, but more accessible methods for assessing the blood concentration of factor Xa inhibitors, in particular, a reagent for assessing the level of the antifactor, which is used to determine the blood level of heparin, is being considered. The opinions of experts on the role of assessing the blood level of DOACs and the possibility of tactics for selecting doses of DOACs based on laboratory analysis data are given. |
| format | Article |
| id | doaj-art-ffc81079899a493d8bd1f3463fd6c404 |
| institution | Kabale University |
| issn | 1819-6446 2225-3653 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | Столичная издательская компания |
| record_format | Article |
| series | Рациональная фармакотерапия в кардиологии |
| spelling | doaj-art-ffc81079899a493d8bd1f3463fd6c4042025-08-23T10:00:36ZengСтоличная издательская компанияРациональная фармакотерапия в кардиологии1819-64462225-36532023-07-0119329029710.20996/1819-6446-2023-29222127Current insights into the possible role of laboratory monitoring of effectiveness and safety of direct oral anticoagulantsS. R. Gilyarevsky0N. K. Vereina1M. V. Golshmid2Russian Medical Academy of Continuing Professional EducationSouth-Ural state medical universityRussian Medical Academy of Continuing Professional EducationThe article is devoted to the discussion of modern approaches to the use of laboratory methods to improve the tactics of using direct oral anticoagulants (DOACs) therapy. Clinical situations in which it may be reasonable to use data on the blood concentration of DOACs are given, including very old age, a marked deviation from the norm of body weight or impaired renal function. Data on the role of measuring the blood level of DOACs are considered in cases of the development of diseases or complications in which information is required on the preservation of the anticoagulant effect of DOACs, for example, in the development of severe bleeding or the need for urgent surgical intervention. The advantages and limitations of modern laboratory methods for assessing the blood concentration of DOACs are discussed. It is emphasized that one of the main advantages of using DOACs is the absence of the need to monitor laboratory parameters in most patients. Data from pharmacological studies are presented that may be useful in explaining the mechanisms that determine the higher safety of some DOACs compared to others. Promising methods for assessing the blood level of DOACs, as well as the possibility of using less specific reagents for assessing the concentration of DOACs, are considered. The possibility of using less specific, but more accessible methods for assessing the blood concentration of factor Xa inhibitors, in particular, a reagent for assessing the level of the antifactor, which is used to determine the blood level of heparin, is being considered. The opinions of experts on the role of assessing the blood level of DOACs and the possibility of tactics for selecting doses of DOACs based on laboratory analysis data are given.https://www.rpcardio.online/jour/article/view/2922direct oral anticoagulantsblood concentration of anticoagulantsatrial fibrillationapixabanrivaroxabandabigatran |
| spellingShingle | S. R. Gilyarevsky N. K. Vereina M. V. Golshmid Current insights into the possible role of laboratory monitoring of effectiveness and safety of direct oral anticoagulants Рациональная фармакотерапия в кардиологии direct oral anticoagulants blood concentration of anticoagulants atrial fibrillation apixaban rivaroxaban dabigatran |
| title | Current insights into the possible role of laboratory monitoring of effectiveness and safety of direct oral anticoagulants |
| title_full | Current insights into the possible role of laboratory monitoring of effectiveness and safety of direct oral anticoagulants |
| title_fullStr | Current insights into the possible role of laboratory monitoring of effectiveness and safety of direct oral anticoagulants |
| title_full_unstemmed | Current insights into the possible role of laboratory monitoring of effectiveness and safety of direct oral anticoagulants |
| title_short | Current insights into the possible role of laboratory monitoring of effectiveness and safety of direct oral anticoagulants |
| title_sort | current insights into the possible role of laboratory monitoring of effectiveness and safety of direct oral anticoagulants |
| topic | direct oral anticoagulants blood concentration of anticoagulants atrial fibrillation apixaban rivaroxaban dabigatran |
| url | https://www.rpcardio.online/jour/article/view/2922 |
| work_keys_str_mv | AT srgilyarevsky currentinsightsintothepossibleroleoflaboratorymonitoringofeffectivenessandsafetyofdirectoralanticoagulants AT nkvereina currentinsightsintothepossibleroleoflaboratorymonitoringofeffectivenessandsafetyofdirectoralanticoagulants AT mvgolshmid currentinsightsintothepossibleroleoflaboratorymonitoringofeffectivenessandsafetyofdirectoralanticoagulants |