title: Laboratory assessment of the anticoagulant activity of dabigatran.
abstract: BACKGROUND
  Our aim was to identify laboratory assays in order to assess the anticoagulant effects of dabigatran etexilate (DE).
  
  
  METHODS
  Twenty patients with nonvalvular atrial fibrillation treated on DE (110 mg per os twice daily) and 20 on acenocoumarol were studied. Conventional coagulation tests, endogenous thrombin potential (ETP), thromboelastometry (ROTEM), epinephrine-induced light transmission aggregometry (LTA), and Hemoclot Thrombin Inhibitors (HTI) were performed in all patients.
  
  
  RESULTS
  In ROTEM analysis, the lysis index at 60 minutes was significantly lower in patients receiving DE (P = .011). In LTA, patients on DE showed decreased aggregation compared to those on acenocoumarol, marginally insignificant (P = .068). Regarding ETP, acenocoumarol affected thrombin generation more than dabigatran (area under the curve [AUC], P < .001), while statistically significant associations were detected between dabigatran levels, as determined by the HTI assay, and almost all parameters of ETP assay (AUC, P < .001).
  
  
  CONCLUSIONS
  The role of ETP in estimating anticoagulant activity of dabigatran possibly requires further research.
authors.affiliation: Laboratory of Haematology & Blood Bank Unit, "Attiko" University Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Elias
authors.initials: E
authors.lastname: Kyriakou
authors.affiliation: Second Cardiology Department, "Attiko" University Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Ignatios
authors.initials: I
authors.lastname: Ikonomidis
authors.affiliation: Laboratory of Haematology & Blood Bank Unit, "Attiko" University Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Stylos
authors.affiliation: Department of Pharmacology, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Stefanos
authors.initials: S
authors.lastname: Bonovas
authors.affiliation: Second Cardiology Department, "Attiko" University Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papadakis
authors.affiliation: National Development and Research Institutes, Inc, New York, NY, USA Hellenic Centre for Diseases Control and Prevention, Athens, Greece.
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Nikolopoulos
authors.affiliation: Laboratory of Haematology & Blood Bank Unit, "Attiko" University Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Styliani
authors.initials: S
authors.lastname: Kokoris
authors.affiliation: Laboratory of Haematology & Blood Bank Unit, "Attiko" University Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kalantzis
authors.affiliation: Laboratory of Haematology & Blood Bank Unit, "Attiko" University Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Christine
authors.initials: C
authors.lastname: Economopoulou
authors.affiliation: Second Department of Critical Care Medicine, "Attiko" University Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Kopterides
authors.affiliation: Second Cardiology Department, "Attiko" University Hospital, School of Medicine, University of Athens, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Lekakis
authors.affiliation: Laboratory of Haematology & Blood Bank Unit, "Attiko" University Hospital, School of Medicine, University of Athens, Athens, Greece atsantes@yahoo.com.
authors.forename: Argirios E
authors.initials: AE
authors.lastname: Tsantes
mesh_terms: D000368:Aged; D000991:Antithrombins / Q000008:administration & dosage / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests / Q000295:instrumentation*; D000069604:Dabigatran / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D000991:Antithrombins; D000069604:Dabigatran
keywords: anticoagulants; cardiology; hemostasis