Surveillance des anticoagulants oraux directs

Abstract

Direct oral anticoagulants prescription is continuously increasing, representing 50 % of anticoagulation drug initiation. In opposition with vitamin K antagonists, they seem easier to use, without requiring dose adjustment or biological monitoring. However, there still persist clinical situations requiring, with or without emergency, the correct assessment of patient coagulation state. Knowledge and understanding of their biological and pharmacokinetic properties as well as the design of studies conducted to get their approv al, is a key point to understand the whys and wherefores of their monitoring. To a certain extent, this monitoring can rely on routine laboratory tests, easy to perform and widely available. Nevertheless, accurate assessment is based on specific testing less available. Interpretation of these results requires a full control of pre-analytical points, especially clinical aspects. Algorithms are available, allowing the management of the patient based on both clinical and biological aspects. Antagonisms availability will increase DAO prescriptions as well as asking regarding their monitoring.