ACCF/AHA/HRS guidelines for AF recommend dabigatran
MedWire News: Updated atrial fibrillation (AF) guidelines from the American College of Cardiology Foundation (ACCF), American Heart Association (AHA), and Heart Rhythm Society (HRS) recommend dabigatran as a suitable alternative to warfarin for the reduction of stroke and thrombosis risk in patients with nonvalvular forms of the arrhythmia.
The recommendation follows the approval of dabigatran 150 mg for this purpose by the US Food and Drug Administration in October 2010.
Findings from the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) study, reported by MedWire News earlier this year, showed dabigatran 150 mg twice-daily to have similar safety and efficacy to warfarin in AF patients.
These results were "considered important enough to prompt a focused update of the ACC/AHA/European Society of Cardiology (ESC) 2006 Guidelines for the Management of Patients with AF" says the writing committee of the guideline update.
The guidelines, published in the Journal of the American College of Cardiology, and the journals Circulation and Heart Rhythm, state that dabigatran should be used as an alternative to warfarin only in paroxysmal or permanent AF patients who have risk factors for strokes or blood clot formation. However, those with prosthetic heart valves, significant valvular disease, severe renal failure, or advanced liver disease should not take the drug.
The writing committee, led by Samuel Wann (Wisconsin Heart Hospital, Milwaukee, USA), emphasizes that "because of the twice-daily dosing and greater risk of nonhemorrhagic side effects with dabigatran, patients already taking warfarin with excellent international normalized ratio (INR) control may have little to gain by switching to dabigatran."
The 2006 AF guidelines were last updated in December 2010, at which time, dual therapy with aspirin and clopidogrel was recommended for the prevention of blood clot formation and stroke in AF patients with contraindications to warfarin therapy.
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By Lauretta Ihonor