Dabigatran associated with increased risk of acute coronary events

Commentary on: Uchino K, Hernandez AV. Dabigatran association with higher risk of acute coronary events: meta-analysis of noninferiority randomized controlled trials. Arch Intern Med 2012;172:397–402. Context The novel oral anticoagulants, comprised of direct thrombin inhibitors (DTIs) (ie, dabigatran) and the factor Xa inhibitors (ie, rivaroxaban, apixaban and edoxaban), are revolutionising the way patients are anticoagulated. Recent years have witnessed a surge of trials evaluating these drugs in many clinical contexts. However, with such rapid uptake, it becomes critical to carefully evaluate safety data in order to optimise patient selection and minimise risk. The largest of the contemporary trials with dabigratran, the Randomised Evaluation of Long-term Anticoagulation (RE-LY), randomised 18 113 patients with atrial fibrillation to either dabigratran or warfarin and reported a 34% relative risk reduction in stroke and systemic embolism with 150 mg of dabigatran twice daily.1 For unclear reasons, there was a 38% increase in...

Source: Evidence-Based Medicine - January 17, 2013 Category: Internal Medicine Authors: Kohli, P., Cannon, C. P. Tags: Electronic pages Source Type: research