Thrombelastography detects dabigatran at therapeutic concentrations in vitro to the same extent as gold-standard tests

International Journal of Cardiology
Sacha SolbeckPär I Johansson

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

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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
Mar 29, 2019·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
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
Mar 27, 2021·Shock·Jason B BrillBryan A Cotton

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