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Thromb Haemost 2012; 107(05): 838-847
DOI: 10.1160/TH11-10-0718
Review Article
Schattauer GmbH

Dabigatran etexilate for stroke prevention in patients with atrial fibrillation: Resolving uncertainties in routine practice

Menno V. Huisman
1   Departments of Thrombosis and Haemostasis, Leiden University Medical Center, Leiden, The Netherlands
,
Gregory Y. H. Lip
2   University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK
,
Hans-Christoph Diener
3   Department of Neurology, University Hospital Essen, Essen, Germany
,
Martina Brueckmann
4   Global Clinical Development and Medical Affairs, Boehringer Ingelheim GmbH & Co. KG, Ingelheim, Germany
,
Joanne van Ryn
5   Department of CardioMetabolic Disease Research, Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach an der Riss, Germany
,
Andreas Clemens
4   Global Clinical Development and Medical Affairs, Boehringer Ingelheim GmbH & Co. KG, Ingelheim, Germany
› Author Affiliations
Further Information

Publication History

Received: 18 October 2011

Accepted after minor revision: 29 January 2011

Publication Date:
25 November 2017 (online)

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Summary

Dabigatran etexilate is a new oral anticoagulant recently approved in Europe for the prevention of stroke or systemic embolism in adult patients with non-valvular atrial fibrillation (AF) and at least one risk factor for stroke. With a fast onset of action and a predictable anticoagulant effect obviating the need for coagulation monitoring, dabigatran etexilate offers practical advantages over vitamin K antagonists in clinical practice. However, clinicians may have questions about practical aspects of dabigatran etexilate use including monitoring anticoagulant efficacy, interruption for surgical or invasive procedures and management of bleeding. This review article aims to address these concerns and provide guidance on the use of dabigatran etexilate in special situations, such as acute coronary syndromes and cardiac revascularisation. In addition, cut-off values for different coagulation assay results associated with an increased risk of bleeding are given.

Note: The editorial process for this article was fully handled by Prof. Christian Weber, Editor-in-Chief.

Keywords

Dabigatran - atrial fibrillation - oral anticoagulant - bleeding
 

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