title: Warfarin versus dabigatran etexilate: an assessment of efficacy and safety in patients with atrial fibrillation.
abstract: BACKGROUND
  Oral anticoagulation is the mainstay for stroke and thromboembolic event prevention in patients with atrial fibrillation (AF). Given limitations of warfarin therapy, non-vitamin K oral anticoagulants have been developed including direct thrombin inhibitors (i.e., dabigatran etexilate). Dabigatran etexilate has been tested thoroughly in terms of efficacy and safety in clinical trials and studies, involving 'real-world' cohorts. In this review, currently available evidence in patients with non-valvular AF is discussed.
  
  
  METHODS
  The pharmacology, efficacy and safety, and current aspects of use of dabigatran etexilate in patients with non-valvular AF are reviewed in a comparative manner to warfarin both for chronic anticoagulation and in different clinical settings.
  
  
  CONCLUSIONS
  Dabigatran etexilate appeared to have several pharmacokinetic and pharmacodynamic advantages over warfarin, as well as a favorable efficacy and safety profile being at least noninferior and often superior to warfarin in patients with non-valvular AF. The latter was shown in the clinical trials, meta-analyses and studies with 'real-world' data. Currently ongoing trials will expand the body of evidence on warfarin and will aid decision making in currently controversial areas. Important limitations of dabigatran etexilate include contraindications for its use in patients with prosthetic heart valves and end-stage chronic kidney disease.
authors.affiliation: University of Birmingham Centre for Cardiovascular Sciences, City Hospital , Birmingham B18 7QH , UK.
authors.forename: Mikhail S
authors.initials: MS
authors.lastname: Dzeshka
authors.forename: Gregory Yh
authors.initials: GY
authors.lastname: Lip
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D001562:Benzimidazoles / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D000075202:Contraindications; D000069604:Dabigatran; D006801:Humans; D055118:Medication Adherence; D008955:Models, Cardiovascular; D011725:Pyridines / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D014859:Warfarin / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D001562:Benzimidazoles; D011725:Pyridines; D014859:Warfarin; D000069604:Dabigatran
keywords: atrial fibrillation; dabigatran etexilate; efficacy; oral anticoagulation; safety; warfarin