Use of DOAC Dipstick point-of-care testing in patients with acute stroke and transient ischemic attack

Introduction In acute stroke or transient ischemic attack (TIA), rapid information about the plasma concentration of direct oral anticoagulants (DOAC) is important for treatment decisions such as systemic thrombolysis, endovascular therapy, or antidote administration in case of hemorrhagic stroke. As standard coagulation assays are either not sufficiently reliable or have long turn-around times, point-of-care-testing with DOAC dipstick may be of additional value in this setting.

Method About 250 patients with acute stroke within the past 24 hours, aged >18 years, admitted to the emergency care units at two centers will be included into the study after having obtained written informed consent. Biographic data, therapeutic interventions, global and specific chromogenic substrate assays, routine clinical chemistry parameters and DOAC Dipstick tests are documented or measured as soon as possible and within eight hours after admission to hospital. DOAC Dipstick results are obtained from urine samples analyzed immediately after sampling. Colors of the specific factor Xa and thrombin inhibitor pads are analyzed visually and by a reader for presence of DOACs. Data will be analyzed by SAS software for primary outcome and for interfering factors.

Results The ongoing bi-center observational prospective study is the first on patients with acute ischemic stroke, hemorrhagic stroke or TIA under real-life conditions. It intends to retrieve an unequivocal test result as early as possible and within 8 hours after stroke unit admission. Moreover, the comparability of visual and reader data of DOAC Dipstick will be analyzed.

Conclusion Preliminary results of this on-going study will be presented at the conference.

Publication History

Article published online:
20 February 2023