CorrespondenceStability of direct oral anticoagulants in whole blood and plasma from patients in steady state treatment

•In whole blood, all DOACs were stable for up to 2 h.•In plasma, rivaroxaban and apixaban were stable for up to 8 h at 20-25 °C.•In plasma, rivaroxaban and apixaban were stable for up to 48 h at 5 °C.•Rivaroxaban was the only freeze-thaw stable DOAC.•Laboratories have to consider these differences before analysis of DOACs.

Using functional haemostasis assays, we demonstrated important differences in stability of direct oral anticoagulants (DOACs) in citrated whole blood and plasma from DOAC treated patients. Laboratories and clinicians should take this into consideration and adjust clinical practices accordingly.