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Dabigatran - alternative to warfarin in atrial fibrillation treatment

Posted Feb 23 2011 12:00am

Heart.org - The newly approved medication dabigatran is an alternative to warfarin (Coumadin) to help prevent dangerous blood clots in patients with atrial fibrillation, according to updated guidelines from the American College of Cardiology, American Heart Association and the Heart Rhythm Society. This will be welcome news for many who have found using warfarin (Coumadin) problematic not only because it is often difficult to regulate the dose, but also because warfarin may cause some unhealthy effects with long-term use (because it interferes with vitamin K function in the body).

The “Focused Update” - published in Circulation: Journal of the American Heart Association, Journal of the American College of Cardiology and HeartRhythm Journal - specifically updates the section on emerging antithrombotic agents ["blood thinners"] in atrial fibrillation treatment guidelines released by the three organizations on Dec. 20, 2010.

Atrial fibrillation is an irregular heart rhythm that occurs when the heart’s two upper chambers beat erratically, causing the chambers to pump blood rapidly, unevenly and inefficiently. Blood can pool and clot in the chambers, increasing the risk of stroke or heart attack. More than two million Americans live with the condition.

According to this most recent update, dabigatran is useful as an alternative to warfarin to prevent stroke and blood clots in patients with either paroxysmal (recurrent episodes that stop after seven days) or permanent (an on-going episode) atrial fibrillation, and with risk factors for stroke or blood clotting who do not have a prosthetic heart valve, significant heart valve disease, severe renal failure or advanced liver disease.

Warfarin, an anti-clotting drug used since the 1950s, requires patients to have regular testing to monitor its effectiveness and dosage adjustment.

In December 2010 the atrial fibrillation guidelines were updated and recommended that a combination of aspirin and the oral antiplatelet drug clopidogrel might be considered to prevent stroke or other types of blood clots in patients with atrial fibrillation who are poor candidates for the clot-preventing drug warfarin.

Dabigatran - Alternative to Coumadin - Highlights:

• A new anti-clotting drug, dabigatran, is added to recommendations for treating atrial fibrillation.
• Dabigatran is an alternative to the anti-clotting drug warfarin (Coumadin).
• Previous recommendations for warfarin still stand.

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