Abstract
The assessment of the anticoagulant effect of direct oral anticoagulants (DOACs) can
be important for rapid medical decision-making, especially in patients needing immediate
management. An assay that screens for the absence or presence of a DOAC would help
accelerate treatment in these situations. Chromogenic and coagulation methods have
several limitations, including limited accuracy, long turnaround time, and their need
of specialized laboratories. Oral factor Xa and thrombin inhibitors are also eliminated
by the kidneys and can be detected in patient urine samples using a single, rapid,
sensitive, and patient-specific qualitative assay. In these tests, the presence or
absence of a DOAC in urine can be identified by visually observing specific colors
after a few minutes. Several studies have demonstrated the robustness and repeatability
of these assays. The specific colors of the test strip also detect creatinine in the
urine, which shows whether DOAC excretion is reduced, thus suggesting renal impairment.
Persons with amblyopia may use a specific reader. Current indications for using the
DOAC Dipstick test include emergency medical situations with severe bleeding and thrombotic events
or before urgent major surgical interventions to accelerate medical decision-making.
Keywords
direct oral anticoagulants - anticoagulants - methods - mass spectrometry - urine
