title: A novel μ-fluidic whole blood coagulation assay based on Rayleigh surface-acoustic waves as a point-of-care method to detect anticoagulants.
abstract: A universal coagulation test that reliably detects prolonged coagulation time in patients, irrespective of the anticoagulant administered, has not been available to date. An easily miniaturised, novel μ-fluidic universal coagulation test employing surface acoustic waves (SAW) is presented here. SAW was employed to instantly mix and recalcify 6 μl citrated whole blood and image correlation analysis was used to quantify clot formation kinetics. The detection of clinically relevant anticoagulant dosing with old anticoagulants (unfractionated heparin, argatroban) and new anticoagulants (dabigatran, rivaroxaban) has been tested and compared to standard plasma coagulation assays. The applicability of this novel method has been confirmed in a small patient population. Coagulation was dose-proportionally prolonged with heparin, argatroban, dabigatran, and rivaroxaban, comparable to standard tests. Aspirin and clopidogrel did not interfere with the SAW-induced clotting time (SAW-CT), whereas the strong GPIIb/IIIa-inhibitor abciximab did interfere. Preliminary clinical data prove the suitability of the SAW-CT in patients being treated with warfarin, rivaroxaban, or dabigatran. The system principally allows assessment of whole blood coagulation in humans in a point-of-care setting. This method could be used in stroke units, emergency vehicles, general and intensive care wards, as well as for laboratory and home testing of coagulation.
authors.affiliation: J.W. Goethe University Hospital, Institute for Clinical Pharmacology, Theodor-Stern-Kai 7 60590 Frankfurt.
authors.forename: Sascha
authors.initials: S
authors.lastname: Meyer Dos Santos
authors.affiliation: J.W. Goethe University Hospital, Institute for Clinical Pharmacology, Theodor-Stern-Kai 7 60590 Frankfurt.
authors.forename: Anita
authors.initials: A
authors.lastname: Zorn
authors.affiliation: Ibidi GmbH, Am Klopferspitz 19, 82152 Martinsried.
authors.forename: Zeno
authors.initials: Z
authors.lastname: Guttenberg
authors.affiliation: J.W. Goethe University Hospital, Institute for Clinical Pharmacology, Theodor-Stern-Kai 7 60590 Frankfurt.
authors.forename: Bettina
authors.initials: B
authors.lastname: Picard-Willems
authors.affiliation: J.W. Goethe University Hospital, Center for Internal Medicine-Cardiology, Theodor-Stern-Kai 7 60590 Frankfurt.
authors.forename: Christina
authors.initials: C
authors.lastname: Kläffling
authors.affiliation: J.W. Goethe University Hospital, Department of Vascular and Endovascular Surgery, Theodor-Stern-Kai 7 60590 Frankfurt.
authors.forename: Karen
authors.initials: K
authors.lastname: Nelson
authors.affiliation: J.W. Goethe University Hospital, Institute for Clinical Pharmacology, Theodor-Stern-Kai 7 60590 Frankfurt.
authors.forename: Ute
authors.initials: U
authors.lastname: Klinkhardt
authors.affiliation: J.W. Goethe University Hospital, Institute for Clinical Pharmacology, Theodor-Stern-Kai 7 60590 Frankfurt.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Harder