Table 1 Clinical and research tests available for the assessment of plasma dabigatran concentration
Test | Sensitivity to plasma dabigatran concentration | Availability | Clinical recommendation |
|---|---|---|---|
Thrombin time | Linear dose response; oversensitive | Widely available | Recommended for detection of presence or absence of dabigatran activity |
Activated partial thromboplastin time (aPTT) | Non-linear dose response | Widely available | Recommended for semi-quantitative estimation of dabigatran activity; normal aPTT does not always exclude presence of dabigatran |
Direct thrombin inhibition assays | Linear dose response; sensitive | Usually available in specialised centres | Recommended for measurement of plasma concentration; ECT usually a local assay because commercial kits not available; not validated for dabigatran |
 Diluted thrombin time | |||
 Ecarin clotting time (ECT) | |||
Thromboelastometry (ROTEM®)/thrombelastography (TEG®) assays EXTEM/Rapid TEG | Sensitive | Limited availability | Potential measurement of effectiveness of treatment for dabigatran-induced anticoagulation; not validated for dabigatran |
Thrombin-generation assays | Sensitive (lag time) | Limited availability | Potential measurement of effectiveness of treatment for dabigatran-induced anticoagulation; not validated for dabigatran |
Prothrombin time or international normalised ratio | Low sensitivity | Widely available | Not recommended in this setting |