Laboratorijska dijagnostika kod primjene direktnih oralnih antikoagulanata

master's thesis

• Title (english): Laboratory diagnostics of direct oral anticoagulants
• Author: Petra Gluščić
• Mentor: Marija Grdić Rajković (mentor)
• Committee member: Marija Grdić Rajković (predsjednik povjerenstva)
• Committee member: Lovorka Vujić (član povjerenstva)
• Committee member: Andrea Čeri (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of medical biochemistry and haematology); Zagreb
• Defense date and country: 2024-11-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

U svijetu je vidljiv trend porasta incidencije tromboembolijskih bolesti, a glavni alat u kontroli ovih
bolesti predstavljaju antikoagulansi. Sa sve većom upotrebom direktnih oralnih antikoagulansa u
liječenju ovih bolesti, javljaju se novi izazovi za kliničke laboratorije. Iako su DOAK-i lijekovi za
koje nije potrebno rutinsko praćenje, postaje jasno da određene situacije ipak zahtijevaju njihovo
određivanje. Ovaj rad donosi pregled recentnih znanstvenih spoznaja o laboratorijskim pretragama
koje se mogu koristiti za određivanje koncentracije DOAK-a te objašnjava utjecaj DOAK-a na
tradicionalne probirne pretrage hemostaze. Jasno je da rutinski testovi poput PV, APTV ili TV nisu
dovoljno osjetljivi za procjenu antikoagulacijskog učinka ili čak detekciju DOAK-a u pacijenata, ali
je važno da su laboratoriji upoznati s utjecajem DOAK-a na ove pretrage. Za određivanje
koncentracije DOAK-a u plazmi mogu se koristiti specifične kromogene i koagulometrijske metode;
za izravne inhibitore trombina diluirano trombinsko vrijeme, ekarinska kromogena metoda,
ekarinski koagulometrijski test i anti-FIIa test, a za izravne inhibitore FXa anti-FXa test.

Abstract (english)

There is a prominent global trend of increasing incidence of thromboembolic diseases, and
the main tool for controlling these conditions is anticoagulant therapy. With the growing use
of direct oral anticoagulants (DOACs) in the treatment of these diseases, new challenges are
emerging for clinical laboratories. Although DOACs do not require routine monitoring, it is
becoming clear that certain situations do require their measurement. This paper provides an
overview of recent scientific findings on laboratory tests that can be used to determine DOAC
concentrations and explains the impact of DOACs on traditional hemostasis screening tests.
It is evident that routine tests such as PT, aPTT, or TT are not sensitive enough to assess the
anticoagulant effect or even detect DOACs in patients, but it is important that laboratories
are aware of the impact of DOACs on these tests. Specific chromogenic and coagulometric
methods can be used to determine DOAC concentrations in plasma; for direct thrombin
inhibitors, diluted thrombin time, ecarin chromogenic method, ecarin clotting test, and antiFIIa test can be used, while for direct factor Xa inhibitors, the anti-FXa test is appropriate.

• Keywords: direktni oralni antikoagulansi; laboratorijska dijagnostika; koagulacijski testovi
• Keywords (english): direct oral anticoagulants; laboratory diagnostics; coagulation assays
• Language: croatian
• URN:NBN: urn:nbn:hr:163:760990
• Study programme: Title: Pharmacy - integrated undergraduate and graduate - university study; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: sveučilišni magistar farmacije (sveučilišni magistar farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2025-02-05 12:06:41