Aaron Goodman: Effects of DOACs on Tests of Hemostasis
Aaron Goodman shared a post on X:
”DOAC Jewels – Tweetorial.
Effects of DOACs on Tests of Hemostasis.
- All increased PT (dabigatran slightly).
- All increased PTT (rivaroxaban/apixaban very slightly).
Mixing studies demonstrate incomplete correction.
Dabigatran can falsely increase fibrinogen. Only dabigatran increases TT.
Anticoagulant Mechanism Name Jewels!
Drugs target Xa = Xa in name:
- ApiXaban,
- BetriXaban,
- EdoXaban,
- RivaroXaban.
Drugs target BOTH Xa+thrombin = PARIN (pair) in name:
- HeParin,
- EnoXaParin,
- DalteParin.
Drugs target only IIa = B (2nd letter):
- ArgatroBan,
- Bivalrudin,
- DaBigatran.
- Dabigatran: 80%,
- Rivaroxaban: 66%,
- Edoxaban: 40%,
- Apixaban: 25%,
- Betrixaban: 11%.
To remember order from worst to best to give for patients with renal impairment: DR. Ed ABe.
Lets reverse this now!
- Warfarin equals the inhibition of factors II,VII,IX,X.
- Reverse equals Vitamin K, 4 factor PCC (II,VII, IX, X).
- Heparin equals the inhibition of factors II,X.
- Reverse equals the Protamine (binds heparin).
- Dabigatran equals the inhibition of factor II.
- Reverse equals Idacrucizumab (MAB to dabigatran).
- Xa inhibitors (Apixaban).
- Reverse equals Andexanet (Xa decoy binds drug).”
Source: Aaron Goodman/X
Aaron Goodman is a Hematologist/ Oncologist and an Associate Professor of Medicine at the University of California, San Diego. He is a member of the National Comprehensive Cancer Network (NCCN) guideline committee for both cutaneous NHLs and T-cell NHLs. Dr. Goodman is a well-known physician-scientist, educator, advocate, and social media influencer.