Determination of dabigatran in plasma, serum, and urine samples: comparison of six methods

被引：22

作者：

Du, Shanshan ^{[1
]}

Weiss, Christel ^{[2
]}

Christina, Giese ^{[1
]}

Kraemer, Sandra ^{[1
]}

Wehling, Martin ^{[1
]}

Kraemer, Roland ^{[3
]}

Harenberg, Job ^{[1
]}

机构：

[1] Heidelberg Univ, Med Fac Mannheim, Clin Pharmacol Mannheim, D-68169 Mannheim, Germany

[2] Heidelberg Univ, Biometry & Stat Med Fac Mannheim, D-68169 Mannheim, Germany

[3] Heidelberg Univ, Inst Inorgan Chem, D-68169 Mannheim, Germany

来源：

CLINICAL CHEMISTRY AND LABORATORY MEDICINE | 2015年 / 53卷 / 08期

关键词：

chromogenic substrate methods; clotting time assays; dabigatran; plasma; serum; urine; PARTIAL THROMBOPLASTIN TIME; DIRECT THROMBIN INHIBITOR; COAGULATION ASSAYS; ORAL ANTICOAGULANTS; CLOTTING TIME; FACTOR XA; LC-MS/MS; APIXABAN; ROUTINE; PHENPROCOUMON;

D O I：

10.1515/cclm-2014-0991

中图分类号：

R446 [实验室诊断]; R-33 [实验医学、医学实验];

学科分类号：

1001 ;

摘要：

Background: Assessing the anticoagulant effect of dabigatran may be useful in certain clinical settings. When plasma sampling is not available, serum or urine samples may provide another option for dabigatran determinations. Methods: Dabigatran was assessed in patients on treatment under real-life conditions in plasma samples by four clotting time-based assays and in plasma, serum, and urine samples by two chromogenic substrate methods. Results: The concentrations of dabigatran in patients' plasma samples were not different for the Hemoclot test (106.8 +/- 89.4 ng/mL) and the ecarin clotting time (ECT, 109.5 +/- 74.5 ng/mL, p=0.58). Activated partial thromboplastin time and prothrombinase-induced clotting time showed low correlations with the other assays. Chromogenic assays measured similar concentrations as Hemoclot and ECT. For both chromogenic assays, the concentrations of dabigatran were about 70% lower in serum than in plasma samples (p<0.0001). The intra-class coefficient (ICC, Bland-Altman analysis) was strong comparing ECT, Hemoclot thrombin inhibitor (HTI) assay, and the two chromogenic assays (r=0.889-0.737). The ICC was low for comparisons of the chromogenic assays of serum vs. plasma values (ICC, 0.15 and 0.66). The ICC for the determination of dabigatran in urine samples by the two chromogenic assays (5641.6 +/- 4319.7 and 4730.0 +/- 3770.2 ng/mL) was 0.737. Conclusions: ECT, HTI, and chromogenic assays can be used to determine dabigatran in plasma samples from patients under real-life conditions. Chromogenic assays require further improvement to reliably measure dabigatran in serum samples. Dabigatran concentrations in urine samples can also be determined quantitatively.

引用

页码：1237 / 1247

页数：11

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