Abstract
The oral direct thrombin inhibitor dabigatran effectively prevents arterial and venous
thromboembolism using fixed doses without the need for adjustment according to laboratory
results. Dabigatran is eliminated from the circulation by ∼80% through the kidneys.
However, the in vitro anticoagulant effect of dabigatran may be necessary to determine
in special patient populations such as in the elderly, for renal impairment, before
operations, bleeding or thrombotic episodes, and to monitor self-compliance. Several
clotting and thrombin-specific chromogenic substrate assays are available to analyze
the biological activity of dabigatran. All of them are prolonged in the presence of
dabigatran. This article reports the effects of dabigatran on clinical routine assays
and the potential usefulness for determination in special risk groups of patients
when overdose or lack of compliance are suspected.
Keywords
dabigatran - Hemoclot assay - chromogenic assay - prothrombin-induced clotting time
assay - Ecarin clotting time - prothrombin time - activated partial thromboplastin
time
