Abstract
Background
Stroke and systemic thromboembolism remain critical causes of mortality and morbidity
in patients with paroxysmal or persistent atrial fibrillation. Dabigatran etexilate
is a novel oral direct thrombin inhibitor, which provides stroke risk reduction for
patients with nonvalvular atrial fibrillation. Randomized clinical data demonstrate
dabigatran to be an alternative oral anticoagulant with an improved efficacy profile
compared with oral warfarin dose adjusted to an INR (international normalized ratio)
target of 2.0 to 3.0.
Objectives
Our aim was to review the pharmacology, mechanism of action, drug metabolism, and
clinical trial data supporting dabigatran use.
Methods
We reviewed all the major published clinical studies of dabigatran and analyzed data
regarding practical applications in selected clinical scenarios.
Results
This review provides recommendations for clinicians regarding dosing during invasive
surgical procedures, transitioning off alternative anticoagulants, and a discussion
of storage and handling of the drug.
Conclusions
Our effort should facilitate the safe and effective use of dabigatran in atrial fibrillation.
Key words
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Article info
Publication history
Published online: October 01, 2012
Accepted:
September 10,
2012
Identification
Copyright
© 2012 Elsevier HS Journals, Inc. Published by Elsevier Inc. All rights reserved.
