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Clinical Medicine Reviews in Vascular Health

Lowering the Risk for Thrombus and Stroke in Atrial Fibrillation Patients: Will Dabigatran Replace Warfarin?

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Clinical Medicine Reviews in Vascular Health 2013:5 1-8

Review

Published on 20 Jun 2013

DOI: 10.4137/CMRVH.S6415


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Abstract

The use of oral anticoagulation to reduce stroke risk from thromboembolism has become the cornerstone of management of atrial fibrillation (AF). Dabigatran is a direct thrombin inhibitor which, in contrast to warfarin, does not require regular blood draws for monitoring effect. Randomized controlled studies suggest that dabigatran may be more effective than warfarin at higher doses, without an increased bleeding risk, and equally effective at lower doses, with lower bleeding risk. With these apparent advantages comes a higher cost, and limited use in patients with underlying renal or liver disease. In addition, the inability to measure anticoagulant effect, as with warfarin, presents drawback for clinical use of dabigatran. In this review, we discuss the mechanisms of action, clinical effect, and place in therapy of dabigatran as a possible replacement for warfarin.



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Publishing in Clinical Medicine Reviews in Vascular Health was a pleasant experience. The process was fast and fair. The staff were very professional and we were well informed of the progress of the manuscript.
Dr Abd A Tahrani MD (Birmingham Heartlands Hospital, University of Birmingham, UK)
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