Interv Akut Kardiol. 2011;10(2):82-86
Dabigatran etexilate - a breakthrough in antithrombotic therapy in cardiology?
- Klinika kardiochirurgie FN v Motole, Praha
Dabigatran etexilate belongs to a new group of anticoagulants – oral direct thrombin inhibitors. It has favourable pharmacological
properties which enable uniform dosage without a need for monitoring of the anticoagulant effect. The efficacy and safety of dabigatran
have been established in a number of clinical trials focused on the prevention and treatment of venous thromboembolism. RE-LY,
a recently published trial in patients with atrial fibrillation, demonstrated a reduced risk of stroke and systemic embolism with dabigatran
treatment compared to warfarin as well as a low risk of bleeding and a significant reduction in haemorrhagic stroke. Dabigatran
has been approved for the prophylaxis of venous thromboembolism in hip and knee replacement surgery. Based on the results of the
RE-LY trial, the indications for dabigatran are expected to extend and include the prevention of thromboembolic complications in a wide
range of patients with atrial fibrillation. So far, much less information is available on the appropriateness of dabigatran use in patients
with acute coronary syndromes or in those with artificial heart valves.
Keywords: anticoagulant therapy, dabigatran etexilate, atrial fibrillation, venous thromboembolism
Published: April 14, 2011 Show citation
References
- Testa L, Andreotti F, Biondi Zoccai GG, Burzotta F, Bellocci F, Crea F. Ximelagatran/melagatran against conventional anticoagulation: a meta-analysis based on 22,639 patients. Int J Cardiol. 2007; 122(2): 117-124.
Go to original source... 
Go to PubMed... - Stangier J, Rathgen K, Stähle H, Gansser D, Roth W. The pharmacokinetics, pharmacodynamics and tolerability of dabigatran etexilate, a new oral direct thrombin inhibitor, in healthy male subjects. Br J Clin Pharmacol. 2007; 64(3): 292-303. Go to original source... Go to PubMed...
- Eriksson BI, Dahl OE, Rosencher N, Kurth AA, van Dijk CN, Frostick SP, Prins MH, Hettiarachchi R, Hantel S, Schnee J, Büller HR; RE-NOVATE Study Group. Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, noninferiority trial. Lancet. 2007; 370(9591): 949-956. Go to original source... Go to PubMed...
- Eriksson BI, Dahl OE, Rosencher N, Kurth AA, van Dijk CN, Frostick SP, Kälebo P, Christiansen AV, Hantel S, Hettiarachchi R, Schnee J, Büller HR; RE-MODEL Study Group. Oral dabigatran etexilate vs. subcutaneous enoxaparin for the prevention of venous thromboembolism after total knee replacement: the RE-MODEL randomized trial. J Thromb Haemost. 2007; 5(11): 2178-2185. Go to original source... Go to PubMed...
- Friedman RJ, Dahl OE, Rosencher N, Caprini JA, Kurth AA, Francis CW, Clemens A, Hantel S, Schnee JM, Eriksson BI; REMOBILIZE, RE-MODEL, RE-NOVATE Steering Committees. Dabigatran versus enoxaparin for prevention of venous thromboembolism after hip or knee arthroplasty: a pooled analysis of three trials. Thromb Res. 2010; 126(3): 175-182. Go to original source... Go to PubMed...
- Schulman S, Kearon C, Kakkar AK, Mismetti P, Schellong S, Eriksson H, Baanstra D, Schnee J, Goldhaber SZ; RE-COVER Study Group. Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N Engl J Med. 2009; 361(24): 2342-2352. Go to original source... Go to PubMed...
- Ezekowitz MD, Reilly PA, Nehmiz G, Simmers TA, Nagarakanti R, Parcham-Azad K, Pedersen KE, Lionetti DA, Stangier J, Wallentin L. Dabigatran with or without concomitant aspirin compared with warfarin alone in patients with nonvalvular atrial fibrillation (PETRO Study). Am J Cardiol. 2007; 100(9): 1419-1426. Go to original source... Go to PubMed...
- Connolly SJ, Ezekowitz MD, Yusuf S, Eikelboom J, Oldgren J, Parekh A, Pogue J, Reilly PA, Themeles E, Varrone J, Wang S, Alings M, Xavier D, Zhu J, Diaz R, Lewis BS, Darius H, Diener HC, Joyner CD, Wallentin L; RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009; 361(12): 1139-1151. Go to original source... Go to PubMed...
- Connolly SJ, Ezekowitz MD, Yusuf S, Reilly PA, Wallentin L; Randomized Evaluation of Long-Term Anticoagulation Therapy Investigators. Newly identified events in the RE-LY trial. N Engl J Med. 2010; 363(19): 1875-1876. Go to original source... Go to PubMed...
- Wallentin L, Yusuf S, Ezekowitz MD, Alings M, Flather M, Franzosi MG, Pais P, Dans A, Eikelboom J, Oldgren J, Pogue J, Reilly PA, Yang S, Connolly SJ; RE-LY investigators. Efficacy and safety of dabigatran compared with warfarin at different levels of international normalised ratio control for stroke prevention in atrial fibrillation: an analysis of the RE-LY trial. Lancet. 2010; 376(9745): 975-983. Go to original source... Go to PubMed...
- Nagarakanti R, Ezekowitz MD, Oldgren J, Yang S, Chernick M, Aikens TH, Flaker G, Brugada J, Kamensky G, Parekh A, Reilly PA, Yusuf S, Connolly SJ. Dabigatran versus warfarin in patients with atrial fibrillation: an analysis of patients undergoing cardioversion. Circulation 2011; 123(2): 131-136. Go to original source... Go to PubMed...
- Wann LS, Curtis AB, January CT, et al. 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (updating the 2006 guideline): A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2011; 123: 104-123. Go to original source... Go to PubMed...