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Evaluation of Coaguchek®Pro II coagulation testing device performance to assess direct oral anticoagulant action. The DOAC-CHECK study

Authors

Cristina Legnani
c.legnani@fondazionearianna.org
https://orcid.org/0000-0003-1999-7800
Arianna Anticoagulazione Foundation, Bologna, Italy.
Michela Cini
https://orcid.org/0000-0001-9681-6159
Arianna Anticoagulazione Foundation, Bologna, Italy.
Sophie Testa
Haemostasis and Thrombosis Center, Laboratory Medicine Department, Cremona Hospital, Cremona, Italy.
Alberto Tosetto
Department of Hematology, San Bortolo Hospital, Vicenza, Italy.
Claudia Dellanoce
Haemostasis and Thrombosis Center, Laboratory Medicine Department, Cremona Hospital, Cremona, Italy.
Stefania Bellesso
Department of Hematology, San Bortolo Hospital, Vicenza, Italy.
Giuseppe Carli
https://orcid.org/0000-0002-7078-1143
Department of Hematology, San Bortolo Hospital, Vicenza, Italy.
Ilaria Nichele
Department of Hematology, San Bortolo Hospital, Vicenza, Italy.
Laura Lissandrini
Department of Hematology, San Bortolo Hospital, Vicenza, Italy.
Serena Zorzi
https://orcid.org/0000-0002-7892-7047
Arianna Anticoagulazione Foundation, Bologna, Italy.
Emilia Antonucci
https://orcid.org/0000-0001-9185-2046
Arianna Anticoagulazione Foundation, Bologna, Italy.
Gualtiero Palareti
https://orcid.org/0000-0002-4327-9561
Arianna Anticoagulazione Foundation, Bologna, Italy.

Direct oral anticoagulants (DOAC) measurement is recommended in specific conditions. A point-of-care testing should be used in emergency to qualitatively rule out relevant DOAC concentrations. The DOAC-CHECK Study aims to evaluate whether the use of CoaguChek® Pro II (Roche Diagnostics International Ltd, Rotkreuz, Switzerland) coagulation testing device can provide reliable information in patients treated with DOAC. The study was carried out in two FCSA (Italian Federation of Thrombosis Centers) centers. We choose 3 different concentration thresholds for our analysis (30, 50 and 100 ng/mL) and by ROC curves the ideal cut-off point was selected to be the one that yielded a sensitivity of at least 95% associated with the highest possible specificity. 512 patients were enrolled. For Edoxaban and Rivaroxaban, both CoaguChek® Pro II prothrombin time (PT) and activated partial thromboplastin time (aPTT) tests showed a sensitivity >95% corresponding to satisfying specificity values; negative predictive values resulted in the range 90-100%. At variance, CoaguChek® Pro II PT and aPTT tests did not seem to be useful for identifying Apixaban and Dabigatran concentrations higher than the pre-defined thresholds. Our results suggest that CoaguChek® Pro II coagulation testing device can be used to qualitatively identify relevant concentrations of Edoxaban or Rivaroxaban, but not of Apixaban or Dabigatran.

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How to Cite

Legnani, C., Cini, M., Testa, S., Tosetto, A., Dellanoce, C., Bellesso, S., … Palareti, G. (2022). Evaluation of Coaguchek®Pro II coagulation testing device performance to assess direct oral anticoagulant action. The DOAC-CHECK study. Bleeding, Thrombosis and Vascular Biology, 1(3). https://doi.org/10.4081/btvb.2022.37
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