Stroke Prevention Using the Oral Direct Thrombin Inhibitor Ximelagatran in Patients with Non-Valvular Atrial Fibrillation

2006 ◽  
Vol 21 (4) ◽  
pp. 279-293 ◽  
Author(s):  
Hans-Christoph Diener
Keyword(s):  
Atrial Fibrillation ◽  
Stroke Prevention ◽  
Direct Thrombin Inhibitor ◽  
Thrombin Inhibitor ◽  
Oral Direct Thrombin Inhibitor

scholarly journals Exposure-response for biomarkers of anticoagulant effects by the oral direct thrombin inhibitor AZD0837 in patients with atrial fibrillation

2015 ◽  
Vol 80 (6) ◽  
pp. 1362-1373 ◽  
Author(s):  
Gregory Y. H. Lip ◽  
Lars H. Rasmussen ◽  
S. Bertil Olsson ◽  
Eva Jensen ◽  
Bengt Hamrén ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Direct Thrombin Inhibitor ◽  
Thrombin Inhibitor ◽  
Oral Direct Thrombin Inhibitor ◽  
Exposure Response

scholarly journals Effect of Ximelagatran and Warfarin on Stroke Subtypes in Atrial Fibrillation

2008 ◽  
Vol 35 (2) ◽  
pp. 160-165 ◽  
Author(s):  
Jeanne S. Teitelbaum ◽  
Rüdiger von Kummer ◽  
Knut Gjesdal ◽  
Arni Kristinsson ◽  
Georg Gahn ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
International Normalized Ratio ◽  
Direct Thrombin Inhibitor ◽  
Fixed Dose ◽  
Thrombin Inhibitor ◽  
Stroke Rate ◽  
Stroke Subtype ◽  
Oral Direct Thrombin Inhibitor ◽  
Stroke Outcomes ◽  
Poor Outcome

ABSTRACTBackground and Purpose:The most common stroke subtype among atrial fibrillation (AF) patients not receiving anticoagulants is cardioembolic. In the SPORTIF III and V trials, the oral direct thrombin inhibitor ximelagatran was as effective as warfarin in reducing the risk of stroke in patients with nonvalvular AF. We assessed any differential effect of warfarin versus ximelagatran on the risk and outcome of cardioembolic and noncardioembolic stroke.Methods:7329 patients with AF and ≥1 risk factors for stroke were randomized to treatment with warfarin (target international normalized ratio 2.0-3.0) or fixed-dose ximelagatran. Strokes were classified into specific subtypes. Therapeutic effect of warfarin and ximelagatran, adverse events, and stroke outcomes were assessed according to stroke subtype.Results:The annual stroke rate was low for both cardioembolic (ximelagatran, 0.39%; warfarin, 0.47%) and noncardioembolic stroke (ximelagatran, 0.57%; warfarin, 0.37%). In ischemic strokes, 33.9% (ximelagatran) and 34.3% (warfarin) had strokes of presumed cardioembolic origin. When fatal stroke, disabling stroke, myocardial infarction, and death from any cause were combined as poor outcome, patients with cardioembolic strokes had the highest rate of poor outcome (40%) but this was non- significant.Conclusions:In SPORTIF III and V the efficacy of warfarin and ximelagatran were similar for prevention of cardioembolic and noncardioembolic strokes. Overall outcome tended to be worse following cardioembolic stroke. Ximelagatran has been withdrawn from the market due to hepatic side effects, but similar compounds are presently being studied.

scholarly journals Dabigatran for Stroke Prevention in Nonvalvular Atrial Fibrillation: Answers to Challenging “Real-World” Questions

Thrombosis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Jorge Ferreira ◽  
Daniel Ferreira ◽  
Miguel Viana-Baptista ◽  
Paulo Bettencourt ◽  
Rui Cernadas ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Real World ◽  
Stroke Prevention ◽  
Oral Anticoagulant ◽  
Dabigatran Etexilate ◽  
Direct Thrombin Inhibitor ◽  
Thrombin Inhibitor ◽  
Joint Effort ◽  
Nonvalvular Atrial Fibrillation ◽  
New Oral Anticoagulant

Dabigatran etexilate is a novel, oral, reversible, direct thrombin inhibitor that constitutes a major breakthrough for stroke prevention in patients with nonvalvular atrial fibrillation (AF). Dabigatran was the first new oral anticoagulant approved in Europe and became available in Portugal, for stroke prevention in nonvalvular AF, earlier than in most European countries. This paper is the joint effort of a panel of experts from different specialties and provides information on the use of dabigatran, in anticipation of the challenges that will come with increased usage.

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