{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:22:15Z","timestamp":1772997735245,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["B83C22003920001"],"award-info":[{"award-number":["B83C22003920001"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Lab Hematology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Direct oral anticoagulants (DOACs) have simplified anticoagulant therapy, but plasma level testing (i.e., anti\u2010Xa and anti\u2010IIa activities) remains important in specific clinical situations (e.g., emergency surgery, bleeding, renal impairment, or suspected non\u2010adherence). However, the impact of sample storage on assay reliability is not well defined. This study evaluated the stability and potential systematic errors in DOACs (apixaban, rivaroxaban, edoxaban, dabigatran) plasma levels after 24\u2009h storage under different conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We enrolled 182 patients on one of the four DOACs. Blood samples were collected in duplicate citrated tubes. The first tube was processed within 4\u2009h to obtain baseline values, with plasma successively stored at room temperature, 4\u00b0C, and \u221220\u00b0C for 24\u2009h. The second tube was stored as whole blood at room temperature before measuring DOACs concentrations. DOACs were measured using dedicated clotting or chromogenic assays. Stability was assessed using non\u2010parametric statistics, Passing\u2010Bablok regression, and Bland\u2013Altman analysis, with Acceptable Change Limits based on assay variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All DOACs showed good stability across conditions, with median recoveries ranging from 93% to 102%. No significant proportional errors were observed. Minor constant biases were observed for apixaban (at 4\u00b0C and \u221220\u00b0C), and more consistently for rivaroxaban and edoxaban. Dabigatran showed no significant bias. Variability was generally low (&lt;\u20097%), and most measurements near clinical thresholds remained accurate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DOACs plasma levels remain stable after 24\u2009h storage under various conditions. While minor biases exist, particularly for rivaroxaban and edoxaban, they are unlikely to affect clinical interpretation in most cases. Whenever needed, DOACs measurement can be deferred after blood drawing without jeopardizing results interpretation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ijlh.70042","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T06:43:48Z","timestamp":1766472228000},"page":"418-429","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Measuring Direct Oral Anticoagulant Levels in Laboratory Practice: Impact of Different Storage Conditions of Blood Samples"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6969-8139","authenticated-orcid":false,"given":"Andrea","family":"Sorrentino","sequence":"first","affiliation":[{"name":"Department of Experimental and Clinical Medicine University of Florence  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Rogolino","sequence":"additional","affiliation":[{"name":"Unit of Atherothrombotic Diseases Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Cesari","sequence":"additional","affiliation":[{"name":"Unit of Atherothrombotic Diseases Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2482-6045","authenticated-orcid":false,"given":"Alessia","family":"Bertelli","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine University of Florence  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia Ciarrocca","family":"Taranta","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine University of Florence  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michela","family":"Di Gioia","sequence":"additional","affiliation":[{"name":"Unit of Atherothrombotic Diseases Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Maria","family":"Gori","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine University of Florence  Florence Italy"},{"name":"Unit of Atherothrombotic Diseases Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Betti","family":"Giusti","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine University of Florence  Florence Italy"},{"name":"Unit of Atherothrombotic Diseases Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Poli","sequence":"additional","affiliation":[{"name":"Unit of Atherothrombotic Diseases Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"Tripodi","sequence":"additional","affiliation":[{"name":"IRCCS Ca\u2019 Granda Maggiore Hospital Foundation, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center  Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossella","family":"Marcucci","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine University of Florence  Florence Italy"},{"name":"Unit of Atherothrombotic Diseases Careggi University Hospital  Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijlh.12992"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0217302"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2478\/acph-2022-0034"},{"issue":"5","key":"e_1_2_10_5_1","first-page":"367","article-title":"Evaluation of the In\u00a0Vitro Stability of Direct Oral Anticoagulants in Blood Samples Under Different Storage Conditions","volume":"81","author":"Thuile K.","year":"2021","journal-title":"Scandinavian Journal of Clinical and Laboratory Investigation"},{"key":"e_1_2_10_6_1","article-title":"Impact of DOACs on Laboratory Assays","volume":"16","author":"Douxfils J.","year":"2018","journal-title":"Thrombosis Journal"},{"key":"e_1_2_10_7_1","first-page":"123","article-title":"Stability of DOACs Plasma Levels and Adherence","volume":"163","author":"Gulpen A. 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