ABSTRACT
In the past few decades， heparin and warfarin have been the main anticoagulants used to treat and prevent venous thromboembolism. Recent studies at home and abroad have shown that non-vitamin K antagonist oral anticoagulants （NOACs） have similar or better efficacy and safety in the prevention and treatment of venous thromboembolism and non-valvular atrial fibrillation. NOACs do not require routine coagulation monitoring when used at a fixed dose. However， in special populations or specific scenarios such as emergency surgery， etc.， an overdose or underdose and abnormal metabolism of NOACs may reduce the drug efficacy and safety， so monitoring and evaluating the anticoagulant effect of NOACs is more conducive to the prognosis of patients.This paper briefly reviewed the common laboratory monitoring methods of NOACs and their use in special populations， aiming to explain different monitoring methods for different NOACs and the applicability of NOACs in special populations， and hoping to provide reference for clinical standard monitoring and use of NOACS.
ABSTRACT
Both laboratory monitoring and point-of-care testing (POCT) are the major two methods for monitoring of non-vitamin K antagonist oral anticoagulants. The safety interval of laboratory testing has not been estalished for surveillance and management of bleeding risk associated with NOACs, even though some sensitive measurements of the effects of these novel drugs have already been identified. Only a few studies investigated the effects of POCT, but most of them have positive results. Both laboratory monitoring and POCT are necessary to be evaluated in large clinical studies in patients receiving treatment with non-vitamin K antagonistoral anticoagulants. This paper reviews the latest research on monitoring non-vitamin K antagonist oral anticoagulants (NOACs).
ABSTRACT
Se realizó un estudio descriptivo y retrospectivo para la evaluación económica parcial, del tipo descripción de costos, de la atención hospitalaria y vigilancia de laboratorio de 22 196 pacientes con presunto diagnóstico de dengue, ingresados en 3 hospitales del municipio de Santiago de Cuba durante la epidemia ocurrida en el bienio 2006-2007. Se determinaron los costos directos e indirectos de hospitalización y vigilancia de laboratorio, y se revisó detalladamente la documentación económica existente en los diferentes centros de costes. De la población santiaguera, 2,3 % estaba afectada por dengue, con preponderancia de la forma clásica y confirmación en 50 % de los que ingresaron. Predominaron los costos totales por concepto de hospitalización ($ 11 246 037,18), que representaron 95,1 %, de los cuales 79,8 % provenían de gastos directos y eran superiores a los originados por la vigilancia de laboratorio. Se recomendó realizar una estimación de los gastos generados por la lucha antivectorial y las campañas educativas durante esta epidemia, como complemento de esta investigación.
A descriptive and retrospective study was carried out for the partial economic evaluation, of cost description type, of the hospital care and laboratory monitoring of 22 196 patients with presumptive diagnosis of dengue, admitted in 3 hospitals of Santiago de Cuba municipality during the epidemic occurred in 2006 - 2007. The direct and indirect costs of hospitalization and laboratory monitoring were determined, and the existing economic data were reviewed in detail in different cost centers. Of the Santiago population, 2.3% were affected by dengue, with a predominance of the classic form and confirmation in 50% of those admitted The total expenses for hospitalization ($11 246 037,18) prevailed, representing 95.1%, of which 79.8% came from direct expenses and were higher than those arising from laboratory monitoring. It was recommended to estimate the expenses incurred by the vector control and educational campaigns during this epidemic as a complement of this study.