Abstract
Measurement of direct oral anticoagulants (DOACs) activity is not routinely necessary.
Indeed, evaluation of DOACs plasmatic concentration is discouraged for the majority
of patients, due to the lack of outcome data supporting this approach. Nevertheless,
DOAC measurements may be useful in emergency situations such as serious bleeding events,
need for urgent invasive procedures, and acute ischemic stroke or in managing anticoagulation
in “special populations” not adequately studied in clinical trials, for example the
very elderly or those at the extremes of body weight. The aim of this review is to
describe and summarize the methods for DOACs activity evaluation and the settings
in which their plasma level measurement may be indicated, analyzing indications from
scientific societies and evidence from clinical trials, as well as real world data
on the usefulness of DOACs plasma levels “monitoring.”
Keywords
direct oral anticoagulants - plasma level measurements - coagulation assays - elective
procedures - extreme body weight - elderly
