Back to Journals » Vascular Health and Risk Management » Volume 8

New oral antithrombotics: focus on dabigatran, an oral, reversible direct thrombin inhibitor for the prevention and treatment of venous and arterial thromboembolic disorders

Authors Dahl OE

Received 23 September 2011

Accepted for publication 7 December 2011

Published 25 January 2012 Volume 2012:8 Pages 45—57

DOI https://doi.org/10.2147/VHRM.S26482

Review by Single-blind

Peer reviewer comments 2

Ola E Dahl1,2
1
Department of Orthopaedics, Innlandet Hospital Trust, Elverum Central Hospital, Elverum, Norway; 2Thrombosis Research Institute, London, UK

Abstract: Venous thromboembolism, presenting as deep vein thrombosis or pulmonary embolism, is a major challenge for health care systems. It is the third most common vascular disease after coronary heart disease and stroke, and many hospitalized patients have at least one risk factor. In particular, patients undergoing hip or knee replacement are at risk, with an incidence of asymptomatic deep vein thrombosis of 40%–60% without thromboprophylaxis. Venous thromboembolism is associated with significant mortality and morbidity, with patients being at risk of recurrence, post-thrombotic syndrome, and chronic thromboembolic pulmonary hypertension. Arterial thromboembolism is even more frequent, and atrial fibrillation, the most common embolic source (cardiac arrhythmia), is associated with a five-fold increase in the risk of stroke. Strokes due to atrial fibrillation tend to be more severe and disabling and are more often fatal than strokes due to other causes. Currently, recommended management of both venous and arterial thromboembolism involves the use of anticoagulants such as coumarin and heparin derivatives. These agents are effective, although have characteristics that prevent them from providing optimal anticoagulation and convenience. Hence, new improved oral anticoagulants are being investigated. Dabigatran is a reversible, direct thrombin inhibitor, which is administered as dabigatran etexilate, the oral prodrug. Because it is the first new oral anticoagulant that has been licensed in many countries worldwide for thromboprophylaxis following orthopedic surgery and for stroke prevention in patients with atrial fibrillation, this compound will be the main focus of this review. Dabigatran has been investigated for the treatment of established venous thromboembolism and prevention of recurrence in patients undergoing hip or knee replacement, as well as for stroke prevention in atrial fibrillation patients with a moderate and high risk of stroke.

Keywords: dabigatran etexilate, venous thromboembolism, stroke, prevention, treatment

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Readers of this article also read:

Lipidomics in vascular health: current perspectives

Kolovou G, Kolovou V, Mavrogeni S

Vascular Health and Risk Management 2015, 11:333-342

Published Date: 12 June 2015

Platelet function tests: a comparative review

Paniccia R, Priora R, Alessandrello Liotta A, Abbate R

Vascular Health and Risk Management 2015, 11:133-148

Published Date: 18 February 2015

Telemonitoring: use in the management of hypertension

Sivakumaran D, Earle KA

Vascular Health and Risk Management 2014, 10:217-224

Published Date: 10 April 2014

Metabolic biomarkers for predicting cardiovascular disease

Montgomery JE, Brown JR

Vascular Health and Risk Management 2013, 9:37-45

Published Date: 29 January 2013

Treatment with exenatide once weekly or twice daily for 30 weeks is associated with changes in several cardiovascular risk markers

Chiquette E, Toth PP, Ramirez G, Cobble M, Chilton R

Vascular Health and Risk Management 2012, 8:621-629

Published Date: 12 November 2012

Cerebral blood flow in Alzheimer’s disease

Roher AE, Debbins JP, Malek-Ahmadi M, Chen K, Pipe JG, Maze S, Belden C, Maarouf CL, Thiyyagura P, Mo H, Hunter JM, Kokjohn TA, Walker DG, Kruchowsky JC, Belohlavek M, Sabbagh MN, Beach TG

Vascular Health and Risk Management 2012, 8:599-611

Published Date: 23 October 2012

Accuracy of the ankle-brachial index using the SCVL®, an arm and ankle automated device with synchronized cuffs, in a population with increased cardiovascular risk

Rosenbaum D, Rodriguez-Carranza S, Laroche P, Bruckert E, Giral P, Girerd X

Vascular Health and Risk Management 2012, 8:239-246

Published Date: 17 April 2012