Impact of dabigatran on routine and specific coagulation assays in patients treated by dabigatran

Dabigatran etexilate, as a new oral anti coagulant (NOAC), is a direct thrombin inhibitor, which is used in patients with non-valvular atrial fibrillation, to reduce the risk of stroke. With a half-life-time of 14-17 hours and a renal clearance of 80%, no need of follow up of dabigatran plasma concentration is necessary in normal situations. In case of bleeding, overdose and before (urgent) surgery, it is recommended to investigate plasma levels of dabigatran and activated partial thromboplastin time (APTT). For other purpose coagulation tests are required and the clinician and the laboratory specialist must be aware of the impact of the NOAC’s on the coagulation assays to avoid misinterpreting test results. The aim of our study was to investigate the effect of dabigatran on the thrombin enzyme or -substrate depended routine and specific coagulation assays in patients treated by dabigatran. Until now, most of the studies are in vitro studies with dabigatran spiked plasma.