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Editor-in-chief
Maria Stella Graziani
Deputy Director
Martina Zaninotto
Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali
EIC Assistant
Francesco Busardò
International Advisory Board
Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada
Publisher
Biomedia srl
Via L. Temolo 4, 20126 Milano
Responsible Editor
Giuseppe Agosta
Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282
email: biochimica.clinica@sibioc.it
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ISSN print: 0393 – 0564
ISSN digital: 0392- 7091
BC: Articoli scritti da A. Tosetto
Il laboratorio nella terapia anticoagulante orale
The role of laboratory medicine in monitoring oral anticoagulant therapy
<p>The oral anticoagulant therapy is used in the prevention and treatment of venous and arterial thromboembolism in many different clinical settings. For this purpose, vitamin K antagonists (VKA), which indirectly reduce the activity of factors II, VII, IX and X preventing the vitamin K-mediated carboxylation of specific glutamic acid residues, and direct oral anticoagulants (DOAC), providing direct inhibition of thrombin (factor IIa) or factor Xa, are available. The VKA monitoring represents a daily challenge for clinical laboratories, due to the increasing number of patients, frequency of needed controls and the management complexity. Several solutions have been proposed to improve the management of patients treated by VKA, such as surveillance in dedicated clinics and use of portable monitors to allow patient self-testing and self-management. Although DOAC have been declared not requiring a standard laboratory monitoring, laboratory testing for measuring drug anticoagulant activity is however needed in many situations, such as in case of bleeding or thromboembolic complications, surgery or invasive procedures, suspected overdose and drug interactions, noncompliance or presence of renal or liver disease.</p>
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