Anticoagulants
Anticoagulants, also known as anticoagulants, are drugs that prevent the blood from clotting too quickly. They are often prescribed to reduce the risk of dangerous blood clots that can lead to heart attacks, strokes or pulmonary embolisms. They are particularly important for people with atrial fibrillation, after surgery or with certain cardiovascular diseases.
Which laboratory tests are used?
The type of laboratory test depends on the type of anticoagulant. For warfarin, a vitamin K antagonist, the International Normalized Ratio (INR) test is used. This measures how long it takes the blood to clot and the target is typically 2.0 to 3.0, depending on the condition. For unfractionated heparin, the activated partial thromboplastin time test (aPTT) is used, with a target of 1.5 to 2.5 times the normal value. Direct oral anticoagulants (DOACs) such as dabigatran or rivaroxaban do not normally require regular testing, but in special cases, such as bleeding or before surgery, tests such as the anti-factor Xa test or the diluted thrombin time (TZ) test may be performed.
Why is control important?
Monitoring laboratory tests is crucial to ensure that the medication is working without increasing the risk of bleeding. Too high an INR value for warfarin can lead to bleeding, while too low a value increases the risk of clots. Similarly, the aPTT value for heparin must be in the correct range to avoid both overdosing and underdosing.
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