Abstract
Dabigatran is an oral anticoagulant approved for treatment of non-valvular atrial fibrillation, deep venous thrombosis (DVT), pulmonary embolism and prevention of DVT following orthopedic surgery. Monitoring of the dabigatran level is essential in trauma and bleeding patients but the available plasma-based assays may not sufficiently display its hemostatic effect. This study investigated the in vitro effect of different concentrations of dabigatran on whole blood thrombelastography (TEG) and its correlation to the specific but time-consuming plasma-based tests Hemoclot and Ecarin Clotting Time (ECT). Blood was collected from 8 healthy donors (two females, six males) with a median age of 46 years and it was spiked with dabigatran to a range of plasma concentrations (0, 50, 100, 200 and 400 ng/ml) covering the therapeutic level. Mean TEG R at 0 ng/ml=5.963 min, 50 ng/ml=7.425 min, 100 ng/ml=8.425 min, 200 ng/ml=9.775 min, 400 ng/ml=11.813 min. A significant overall increase (p=0.001) in TEG reaction time (R) was found across increasing dabigatran concentrations i.e. 0 vs 50 vs 100 vs 200 vs 400 ng/ml (p<0.000 p=0.027 p=0.026, p=0.005, respectively). TEG R correlated strongly with Hemoclot (R(2)=0.891, p<0000) and ECT (R(2)=0.914,...Continue Reading
References
Dec 8, 2004·Pathophysiology of Haemostasis and Thrombosis·Götz Nowak
May 18, 2007·British Journal of Clinical Pharmacology·Joachim StangierWilly Roth
Dec 14, 2007·Clinical Pharmacokinetics·Joachim StangierReinhold Fuhr
Mar 31, 2010·Thrombosis and Haemostasis·Joanne van RynAndreas Clemens
Aug 31, 2010·Lancet·Lars WallentinUNKNOWN RE-LY investigators
Oct 19, 2010·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Pär I Johansson
Dec 24, 2011·Current Opinion in Anaesthesiology·Pär I Johansson
Jan 10, 2012·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Joachim Stangier, Martin Feuring
Jul 12, 2012·Thrombosis and Haemostasis·Patrick K DavisFrancis J Castellino
Jan 26, 2013·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Yiming XuZhu Chen
Feb 19, 2013·Anesthesiology·Jerrold H LevyCharles M Samama
Feb 12, 2014·Current Opinion in Anaesthesiology·Jakob StensballePär I Johansson
Aug 27, 2014·International Journal of Cardiology·Sacha SolbeckSisse R Ostrowski
Oct 9, 2014·Blood·Pär I JohanssonJohn B Holcomb
May 1, 2015·Archives of Pathology & Laboratory Medicine·João D DiasLaurel A Omert
Citations
Sep 24, 2016·Critical Care : the Official Journal of the Critical Care Forum·Karen S BrownJerrold H Levy
Jul 26, 2018·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Barbora KorpallováMarián Mokáň
Jul 3, 2018·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Jorell GantioquiAnthony K C Chan
Jun 1, 2018·The Journal of Trauma and Acute Care Surgery·Michael W CrippsPeter E Gales
Nov 2, 2017·Neurosurgical Focus·Svetlana KvintMonisha A Kumar
Oct 6, 2018·Journal of Thrombosis and Haemostasis : JTH·V TauneH Wallén
Mar 29, 2019·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
Jan 7, 2018·Scandinavian Journal of Clinical and Laboratory Investigation·Sacha SolbeckPär I Johansson
Nov 18, 2017·Scandinavian Journal of Clinical and Laboratory Investigation·Willemijn J ComuthAnna-Marie B Münster
Mar 8, 2017·Anaesthesia and Intensive Care·K M Ho, W Pavey
Sep 19, 2020·Anaesthesia·D OberladstätterH Schöchl
Mar 27, 2021·Shock·Jason B BrillBryan A Cotton