ABSTRACT NUMBER: ESOC2026A1384 QUANTITATIVE POINT-OF-CARE TESTING IN PATIENTS TREATED WITH APIXABAN

Abstract Background and aims Despite its clinical benefits, DOAC is associated with 1–2% annual incidence of ischemic stroke, while major bleeding and intracranial hemorrhage occur at rates up to 3.6% and 0.5%, respectively. Consequently, DOAC have become highly relevant during acute ischemic and hemorrhagic stroke where rapid assessment of anticoagulation status is crucial to guide decision-making regarding thrombolysis and anticoagulation reversal. Point-of-care testing have consistently shown weak correlations for apixaban across all platforms. This study aims to evaluate the diagnostic performance of the novel MedicQuant platform for quantitative assessment of apixaban plasma concentrations in blood samples from real-life patients. Methods Plasma obtained by centrifugation from patients receiving apixaban was analyzed using the MedicQuant platform. Liquid chromatography–tandem mass spectrometry (LC-MS/MS) was used for device calibration. Method comparison of laboratory-based calibrated factor-Xa activity (fXa) and MedicQuant platform was performed against LC-MS/MS measurements. Results Conclusions Our study supports the feasibility of quantitative assessment of apixaban plasma concentrations up to 200 ng/mL using the MedicQuant platform. This is the first study to demonstrate a point-of-care test yielding results comparable to those obtained using laboratory-based calibrated factor-Xa activity. Validation studies in emergency settings are required. Conflict of interest JM, AP and SH: Nothing to disclose IB: acted as paid speaker in the past for CSL Behring, Siemens Healthcare Diagnostics Products, AstraZeneca, Octapharma. Performed contract research for Siemens Healthcare Diagnostics Products and Behnk Elektronik and is a member of the advisory board of Alexion and of the expert group of CSL Behring and Siemens Healthcare Diagnostics Products. JD, L.D.F.N and M.H.-B are employed in MedicQuant, an in vitro diagnostic company, specializes in the quantification of DOACs. L.D.F.N and M.H.-B are co-founders of MedicQuant. SP: research support from BMS/Pfizer, Boehringer Ingelheim, Daiichi Sankyo, Helena Laboratories, and Werfen, as well as speakers’ honoraria and consulting fees from Alexion, AstraZeneca, Bayer, Boehringer Ingelheim, BMS/Pfizer, Daiichi Sankyo, Portola, and Werfen, all outside of the submitted work Table 1 - belongs to Results Figure 1 - belongs to Results Figure 2 - belongs to Results