International journal of laboratory hematology
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The introduction of several oral direct anticoagulants within the past 2-3 years has dramatically changed clinical practice and has also impacted on utilization and interpretation of coagulation laboratory testing. This article reviews the effects of the oral thrombin inhibitor, dabigatran, and the oral factor Xa inhibitors, rivaroxaban and apixaban, on screening and diagnostic coagulation tests, and describes methods for measuring the their anticoagulant activity in plasma. Currently, there are evidence gaps regarding the role of laboratory testing for surveillance and management of adverse events associated with these new anticoagulants which do not require routine therapeutic drug monitoring. This is a rapidly changing field, and coagulation laboratory experts have a major role in ensuring patients receive appropriate testing and accurate interpretations of results.
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Comparative Study
Evaluation of Thrombi-Stat MC1 for whole blood and plasma international normalized ratio in comparison with a laboratory method.
The precision and comparability of the international normalized ratio (INR) analyzed by the Thrombi-Stat MC1 coagulation testing system were evaluated before using as a point-of-care testing. ⋯ The precision and comparability to validated method of the Thrombi-Stat MC1 were acceptable. Either citrated whole blood or plasma may be used as samples in this system. Impact on the management of patients must be taken into consideration prior to the implementation of this system.
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Association of P2RY1 and P2RY12 polymorphisms with on-aspirin platelet reactivity was investigated. ⋯ Polymorphisms in P2RY1 and P2RY12 are associated with on-aspirin platelet reactivity in patients with CAD.
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The HPA-15 antigen system is characterized by a low antigen expression on platelets. The antibodies against this antigen are implied in fetal/neonatal alloimmune thrombocytopenia (F/NAIT), post-transfusion purpura, and refractoriness to platelet transfusions. Detection of these antibodies appears to be related to the level of HPA-15 expression on the platelets used in the monoclonal antibody-specific immobilization of platelet antigen (MAIPA) assay. ⋯ Anti-HPA-15 antibody detection should be based on carefully selected platelets with high HPA-15 expression level.