Multianalyte determination of NOACs using LC-MS/MS and comparison with functional coagulation assays

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00098892%3A_____%2F18%3AN0000075" target="_blank" >RIV/00098892:_____/18:N0000075 - isvavai.cz</a>

Alternative codes found

RIV/61989592:15110/18:73589827

Result on the web

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DOI - Digital Object Identifier

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Result language

angličtina

Original language name

Multianalyte determination of NOACs using LC-MS/MS and comparison with functional coagulation assays

Original language description

BACKGROUND: Detection of new oral anticoagulant (NOAC) levels by screening, special and global tests, and liquid chromatography-coupled tandem mass spectrometry (LC-MS/MS) is important in clinical situations when the cause of bleeding needs to be determined. METHODS: We compared a routine coagulation test, special function test for NOACs, global coagulation test, and an LC-MS/MS method that enables simultaneous determination of apixaban, dabigatran and rivaroxaban in human plasma within one analysis to determine the optimal indication of the comparison methods, including their limitations and interferences. RESULTS: This study was conducted on a set of blood samples from 116 patients treated with NOACs. The results of both specific dilute thrombin time (dTT) tests for dabigatran provided the same results as the activated partial thromboplastin time (aPTT) screening test in comparison with LC-MS/MS as a reference. The dTT assay HemosIL showed better results for low concentrations when compared to LC-MS/MS than dTT HYPHEN as HemosIL uses a non-linear calibration curve. Results of the specific anti-Xa assay yielded better results than the prothrombin time test in comparison with LC-MS/MS as a reference, especially for apixaban, but also for rivaroxaban. Our LC MS/MS method is simply feasible, but only in a specialized laboratory. The method is easy-to-use for the simultaneous determination of all dabigatran, apixaban and rivaroxaban by LC-MS/MS within three minutes with a concentration range of 1 to 500 microgram/L without dilution. CONCLUSIONS: In the normal practice of the coagulation laboratory, it is advisable to use specific tests for NOAC determination as screening and global assays are not sufficiently specific. The dTT test is the optimal choice for dabigatran determination and for xabans to determine anti-Xa activity. The LC-MS/MS method is suitable as an arbitration method for serious conditions.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30205 - Hematology

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Clinical Laboratory

ISSN

1433-6510

e-ISSN

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Volume of the periodical

64

Issue of the periodical within the volume

10

Country of publishing house

DE - GERMANY

Number of pages

11

Pages from-to

1611-1621

UT code for WoS article

000447654600002

EID of the result in the Scopus database

2-s2.0-85055071152