ArticleNeurological research and practice2026
Heparin-calibrated anti-factor Xa activity as a surrogate marker for direct oral anticoagulant levels in acute stroke care: a large observational single-center study.
Article in Neurological research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeDirect oral anticoagulants (DOAC) complicate therapeutic decision-making, as rapid assessment of anticoagulant activity is critical in emergency patients, particularly in acute ischemic stroke (AIS). The administration of systemic thrombolysis (IVT) in anti-coagulated patients requires careful risk-benefit evaluation, given the potential for hemorrhagic complications. Substance-specific DOAC plasma level measurements are often unavailable outside tertiary centers. This study evaluated whether widely available heparin-calibrated anti-factor Xa (anti-Xa) activity can reliably estimate clinically relevant DOAC levels and support urgent clinical decision-making.
methodsThis retrospective single-center study (2015-2023) analyzed 969 patients treated with apixaban, rivaroxaban, or edoxaban. All patients had parallel measurements of anti-Xa activity and specific DOAC levels. Correlations were assessed using Spearman's coefficient. Receiver operating characteristic (ROC) analyses were performed to derive anti-Xa cut-off values corresponding to DOAC concentrations of 30, 50, and 100 ng/mL.
resultsAnti-Xa activity strongly correlated with DOAC plasma levels for all substances (Spearman's ρ ≈ 0.95-0.96). ROC analyses demonstrated excellent diagnostic accuracy, with areas under the curve ≥ 0.97 for all evaluated thresholds. Similar anti-Xa cut-offs were observed for apixaban and rivaroxaban, whereas these were lower for edoxaban. For all DOACs combined, anti-Xa cut-offs of approximately 0.36U/mL, 0.56U/mL, and 1.19U/mL corresponded to DOAC levels of 30, 50, and 100ng/mL, respectively, with high sensitivity and specificity.
conclusionsHeparin-calibrated anti-Xa activity is a reliable surrogate marker for clinically relevant DOAC levels. Defined anti-Xa cut-offs are highly specific and sensitive and enable rapid and standardized assessment of anticoagulant activity in this cohort.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.