title: Coagulation assays and anticoagulant monitoring.
abstract: Anticoagulant therapy, including conventional agents and a variety of new oral, fast-acting drugs, is prescribed for millions of patients annually. Each anticoagulant varies in its effect on routine and specialty coagulation assays and each drug may require distinct laboratory assay(s) to measure drug concentration or activity. This review provides an overview of the assorted assays that can measure anticoagulant drug concentration or activity and includes key assay interferences. The effect of these conventional and new anticoagulant agents on specialty coagulation assays used to evaluate for bleeding or clotting disorders, and whether this impact is physiological or factitious, is included. Also provided is a short review of superwarfarin poisoning and features distinguishing this from warfarin overdose. Knowledge of clinically significant pearls and pitfalls pertinent to coagulation assays in relation to anticoagulant therapy are important to optimize patient care.
authors.affiliation: Colorado Coagulation, a business unit of Esoterix Inc, Englewood, CO 80112, USA. adcockd@labcorp.com
authors.forename: Dorothy M Adcock
authors.initials: DM
authors.lastname: Funk
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects*; D001778:Blood Coagulation Disorders / Q000188:drug therapy; D016903:Drug Monitoring; D065427:Factor Xa Inhibitors; D006405:Hematology / Q000379:methods*; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D013917:Thrombin / Q000037:antagonists & inhibitors; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014859:Warfarin / Q000097:blood / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D014812:Vitamin K; D014859:Warfarin; D013917:Thrombin