Dabigatran etexilate – a novel, reversible, oral direct thrombin inhibitor: Interpretation of coagulation assays and reversal of anticoagulant activity

By J. Ryn, J. Stangier, S. Haertter, Karl‐Heinz Liesenfeld, W. Wienen, M. Feuring, A. Clemens. Thrombosis and Haemostasis, 2010

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The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. (2018, result): “The relationship between dabigatran and the aPTT is curvilinear.(229) An aPTT in the normal range does not exclude dabigatran levels in the ‘on therapy’ range, but excludes drug levels above the ‘on therapy’ range when a sensitive assay is used.”
Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report (2012, background): “The dilute TT can be used to quantify dabigatran drug levels as it has good correlation across a wide range of dabigatran concentrations.(212) Chromogenic anti-factor Xa assays are recommended for rivaroxaban, apixaban, and edoxaban with calibration for the specific agent.”
2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation--developed with the special contribution of the European Heart Rhythm Association. (2012, methodology): “However, the lack of normalization of coagulation tests does not necessarily correlate with the absence of an anti-haemorrhagic effect, as shown in animal models.(84) Perioperative management is another important consideration.”