title: [Clinical studies, the interests and limits of using dabigatran in atrial fibrillation].
abstract: Atrial fibrillation (AF) is the most frequent cardiac arrhythmia, especially in older people. This condition is associated with an increased risk of stroke, and long-term anticoagulation treatment is therefore needed. Vitamin K antagonists are effective in reducing the risk of stroke but optimal use of these drugs remains difficult. The development of new oral anticoagulant drugs is therefore highly relevant. Dabigatran is an oral direct thrombin inhibitor. Its prodrug, dabigatran etexilate, is marketed under the name of Pradaxa and was initially approved for the prevention of thromboembolic events in major orthopedic surgery. It has been recently approved for stroke prevention in patients with AF. The purpose of this paper is to review--in light of current knowledge--the interests and limits of using dabigatran etexilate in AF. Briefly, dabigatran etexilate is not inferior to warfarin in AF. However many questions remain unanswered, including questions related to the concomitant use of dabigatran etexilate and acetylsalicylic acid, the possible increased risk of myocardial infarction and the need for drug monitoring.
authors.affiliation: Université Catholique de Louvain, Faculty of Pharmacy and Biomedical Sciences, Belgium.
authors.forename: A
authors.initials: A
authors.lastname: Sternotte
authors.forename: J
authors.initials: J
authors.lastname: Douxfils
authors.forename: B
authors.initials: B
authors.lastname: Chatelain
authors.forename: C
authors.initials: C
authors.lastname: Chatelain
authors.forename: F
authors.initials: F
authors.lastname: Mullier
authors.forename: J M
authors.initials: JM
authors.lastname: Dogné
authors.forename: A
authors.initials: A
authors.lastname: Spinewine
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use; D000931:Antidotes / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D001562:Benzimidazoles / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D000069604:Dabigatran; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic; D010974:Platelet Aggregation / Q000187:drug effects; D020521:Stroke / Q000517:prevention & control; D013923:Thromboembolism / Q000517:prevention & control; D014859:Warfarin / Q000627:therapeutic use; D015091:beta-Alanine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D000931:Antidotes; D001562:Benzimidazoles; D015091:beta-Alanine; D014859:Warfarin; D000069604:Dabigatran