{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:52:24Z","timestamp":1785901944070,"version":"3.56.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"Introduction<\/jats:title>Direct oral anticoagulants (DOACs) have become widely used in clinical practice for preventing thromboembolic events. Point-of-care testing methods, particularly those based on urine samples, offer a promising approach for rapid and accurate assessment of DOAC presence. This pilot study aims to evaluate the utility of a urine-based DOAC dipstick test as a point-of-care tool for identifying DOAB presence in acute ischemic stroke (AIS) or transient ischemic attack (TIA) patients.<\/jats:p><\/jats:sec>Patients and methods<\/jats:title>This prospective pilot study included patients with AIS\/TIA eligible for DOAC-measurement. After exclusion of 3 patients, 23 patients with DOAC-intake (DOAC group; factor-Xa-inhibitors; n<\/jats:italic>\u2009=\u200923) and 21 patients without DOAC-intake (control-group) remained for analyses. The urine-based DOAC dipstick test and parallel blood-based specific DOAC-level assessment were performed in all patients. Time-intervals of sampling urine\/blood sampling and result of DOAC-test were recorded to analyze a potential time benefit based on dipstick evaluation.<\/jats:p><\/jats:sec>Results<\/jats:title>The urine-based DOAC dipstick test demonstrated high sensitivity (100%) and specificity (100%), correctly identifying all patients with anticoagulatory activity due to DOAC intake (i.e., anti-Xalevel \u226530\u2009ng\/mL). Moreover, the visual readout of the test provided semiquantitative information on drug-specific anti-Xa levels, showing a sensitivity of 83% and specificity of 93% to detect anti-Xa levels \u2265120\u2009ng\/mL. The dipstick test exhibited a median time-benefit of 2:25\u2009h compared to standard blood-based DOAC-level testing.<\/jats:p><\/jats:sec>Discussion<\/jats:title>The results of this pilot study underline the efficacy of urine-based point-of-care testing as a rapid and reliable method for assessing DOAC presence in patients with acute ischemic stroke.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>The value of this tool for clinical decision-making in stroke management needs to be established in future trials.<\/jats:p>Clinical Trial Registration<\/jats:bold>: Clinicaltrails.org<\/jats:ext-link> identifier [NCT06037200].<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1330421","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T12:17:27Z","timestamp":1702642647000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Urine-based point-of-care testing for factor-Xa-inhibitors in acute ischemic stroke patients: a feasibility study"],"prefix":"10.3389","volume":"14","author":[{"given":"Thorsten R.","family":"Doeppner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linus","family":"Olbricht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toska","family":"Maxhuni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Alhaj Omar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich J.","family":"Sachs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin B.","family":"Juenemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagen B.","family":"Huttner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan T.","family":"Gerner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1016\/s0140-6736(13)62343-0","article-title":"Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials","volume":"383","author":"Ruff","year":"2014","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.ahj.2017.08.011","article-title":"International trends in clinical characteristics and oral anticoagulation treatment for patients with atrial fibrillation: results from the GARFIELD-AF, ORBIT-AF I, and ORBIT-AF II 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