Monitoring anticoagulant therapy with new oral agents

Table 2 Available coagulation tests to determine the anticoagulant effect of oral anticoagulants

Drug	Coagulation test	Pros	Cons
Dabigatran	aPTT	Highly available	Do not reflect the intensity of coagulation Low specificity
	TT	Highly available	It only determines the effect of dabigatran but lacks specificity
	dTT	Very accurate and precise to estimates plasma concentrations of dabigatran	Requires specific calibrators and controls in specialized laboratories with trained personal Low specificity
	ECT		Requires specific calibrators and controls in specialized laboratories with trained personal Limited standardization and validation required Low specificity Interlot variability reported
	ECA	Very accurate and precise to estimates plasma concentrations of dabigatran	Requires specific calibrators and controls in specialized laboratories with trained personal Low specificity
	DRVV-T		Requires specific calibrators and controls in specialized laboratories with trained personal Low specificity
Rivaroxaban	PT	Highly available	Do not reflect the intensity of coagulation Low specificity
Rivaroxaban and Apixaban	Chromogenic anti-Xa assays	Very accurate and precise to estimates plasma concentrations of dabigatran	Requires specific calibrators and controls in specialized laboratories with trained personal
	DRVV-T		Requires specific calibrators and controls in specialized laboratories with trained personal Low specificity

Any of these tests have been associated with clinical endpoints and data regarding their use in special populations are scarce. aPTT: Activated partial thromboplastin time; DRVV-T: Dilute Russell’s viper venom time; dTT: Dilute thrombin time; ECA: Ecarin chromogenic assay; ECT: Ecarin clotting time; PT: Prothrombin time; TT: Thrombin time.