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Douxfils et al. Thrombosis PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/13485127 Journal 2014, 12:24 http://www.thrombosisjournal.com/content/12/1/REVIEWOpen AccessMeasurement of non-VKA oral anticoagulants versus classic ones: the appropriate use of hemostasis assaysJonathan Douxfils1, Anne Tamigniau2, Bernard Chatelain2, Catherine Goffinet3, Jean-Michel Dogn? and Fran is Mullier1,2*AbstractTraditional anticoagulant agents such as vitamin K antagonists (VKAs), unfractionated heparin (UFH), low molecular weight heparins (LMWHs) and fondaparinux have been widely used in the prevention and treatment of thromboembolic diseases. However, these agents are associated with limitations, such as the need for regular coagulation monitoring (VKAs and UFH) or a parenteral route of administration (S)-1-Boc-2-Hydroxymethyl-piperazine (UFH, LMWHs and fondaparinux). Several non-VKA oral anticoagulants (NOACs) are now widely used in the prevention and treatment of thromboembolic diseases and in stroke prevention in non-valvular atrial fibrillation. Unlike VKAs, NOACs exhibit predictable pharmacokinetics and pharmacodynamics. They are therefore usually given at fixed doses tert-Butyl (7-bromoheptyl)carbamate without routine coagulation monitoring. However, in certain patient populations or special clinical circumstances, measurement of drug exposure may be useful, such as in suspected overdose, in patients experiencing a hemorrhagic or thromboembolic event during the treatment’s period, in those with acute renal failure, in patients who require urgent surgery or in case of an invasive procedure. This article aims at providing guidance on laboratory testing of classic anticoagulants and NOACs. Keywords: Vitamin K antagonist, Dabigatran, Rivaroxaban, Apixaban, Low molecular weight heparin, Enoxaparin, Monitoring, Non-VKA oral anticoagulantsIntroduction Anticoagulants are a mainstay of cardiovascular therapy and, until recently, vitamin K antagonists (VKAs) were the o.
