As NOACs continue to replace warfarin anticoagulant therapy, there are additional considerations for laboratory testing. Laboratory testing is useful whenever over-anticipated anticoagulation is suspected, even in the absence of overt clinical events.
Although NOACs do not require regular dose adjustment based on results of laboratory tests, the measurement of their anticoagulant effect may be needed by patients receiving NOAC treatment in special clinical situations, including:
- Major bleeding
- Need for emergency surgery
- Thromboembolism while receiving NOACs
- Evaluation of the impact of NOAC in particular patients
- Administration of reversal agents in critical bleeding situations
