title: Direct thrombin inhibitors in cardiovascular disease.
abstract: Limitations of commonly used anticoagulants, unfractionated heparin, low-molecular-weight heparin, and oral vitamin K antagonists have prompted the development of alternative therapies. Direct thrombin inhibitors are a new class of anticoagulants that bind directly to thrombin and inhibit its interaction with substrates. In this Review, we critically examine the evidence from randomized controlled trials for the efficacy and safety of the parenteral direct thrombin inhibitors bivalirudin and argatroban, and the novel oral direct thrombin inhibitor dabigatran etexilate, in cardiovascular and thrombotic disease.
authors.affiliation: Michael G. DeGroote School of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4L8, Canada. arsenault.ka@gmail.com
authors.forename: Kyle A
authors.initials: KA
authors.lastname: Arsenault
authors.forename: Jack
authors.initials: J
authors.lastname: Hirsh
authors.forename: Richard P
authors.initials: RP
authors.lastname: Whitlock
authors.forename: John W
authors.initials: JW
authors.lastname: Eikelboom
mesh_terms: D000284:Administration, Oral; D000818:Animals; D000991:Antithrombins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D007263:Infusions, Parenteral; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000991:Antithrombins