{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:01:39Z","timestamp":1790719299632,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,10,8]],"date-time":"2013-10-08T00:00:00Z","timestamp":1381190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>There is increasing recognition that thrombotic complications may occur in patients with cirrhosis, and literature on antithrombotic treatment in these patients is rapidly emerging. Due to extensive haemostatic changes in patients with cirrhosis, careful monitoring of anticoagulant therapy may be required. Recent data suggest that plasma levels of low molecular weight heparin (<jats:styled-content style=\"fixed-case\">LMWH<\/jats:styled-content>) are substantially underestimated by the anti\u2010activated factor X (anti\u2010Xa) assay in patients with cirrhosis. We studied the <jats:italic>in vitro<\/jats:italic> recovery of antithrombin (<jats:styled-content style=\"fixed-case\">AT<\/jats:styled-content>)\u2010dependent and \u2013independent anticoagulant drugs in plasma from 26 patients with cirrhosis and 30 healthy controls and found substantially reduced anti\u2010Xa levels when <jats:styled-content style=\"fixed-case\">AT<\/jats:styled-content>\u2010dependent anticoagulant drugs were added to the plasma of patients with cirrhosis. <jats:styled-content style=\"fixed-case\">LMWH<\/jats:styled-content> (0\u00b72\u00a0U\/ml) had the poorest recovery in plasma from patients with cirrhosis (0\u00b713\u00a0\u00b1\u00a00\u00b706\u00a0U\/ml, compared to 0\u00b723\u00a0\u00b1\u00a00\u00b703\u00a0U\/ml in controls, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b70001), followed by unfractionated heparin and fondaparinux. In contrast, the recovery of rivaroxaban and dabigatran was identical between patients and controls. These data suggest that the anti\u2010Xa assay cannot be used to monitor <jats:styled-content style=\"fixed-case\">AT<\/jats:styled-content>\u2010dependent anticoagulant drugs in patients with cirrhosis, as it substantially underestimates drug levels. The direct factor Xa and <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>a inhibitors, however, may be monitored through the respective anti\u2010Xa and anti\u2010<jats:styled-content style=\"fixed-case\">II<\/jats:styled-content>a assays in patients with cirrhosis.<\/jats:p>","DOI":"10.1111\/bjh.12593","type":"journal-article","created":{"date-parts":[[2013,11,13]],"date-time":"2013-11-13T05:12:18Z","timestamp":1384319538000},"page":"666-673","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":73,"title":["Routine coagulation assays underestimate levels of antithrombin\u2010dependent drugs but not of direct anticoagulant drugs in plasma from patients with cirrhosis"],"prefix":"10.1111","volume":"163","author":[{"given":"Wilma","family":"Potze","sequence":"first","affiliation":[{"name":"Surgical Research Laboratory Department of Surgery University of Groningen University Medical Centre Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freeha","family":"Arshad","sequence":"additional","affiliation":[{"name":"Surgical Research Laboratory Department of Surgery University of Groningen University Medical Centre Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelle","family":"Adelmeijer","sequence":"additional","affiliation":[{"name":"Surgical Research Laboratory Department of Surgery University of Groningen University Medical Centre Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Blokzijl","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology University of Groningen University Medical Centre Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arie P.","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology 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