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• W2890713660 abstract "The management of patients suspected of acute coronary syndromes (ACS) with atrial fibrillation (AF) remains a clinical challenge. Four novel anticoagulants and three different antiplatelet agents at different doses lead to a dizzying number of potential regimen. New oral anticoagulants (NOACs) have been shown not to be inferior to vitamin K antagonists (VKAs) in reducing thromboembolic events in patients with non-valvular AF and venous thrombo-embolism. However, the ones that directly inhibit thrombin (OTI) have been associated with greater risk of myocardial infarction (MI) [ [1] Hohnloser S.H. Oldgren J. Yang S. Wallentin L. Ezekowitz M. Reilly P. Eikelboom J. Brueckmann M. Yusuf S. Connolly S.J. Myocardial ischemic events in patients with atrial fibrillation treated with dabigatran or warfarin in the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial. Circulation. 2012; 125: 669-676 Crossref PubMed Scopus (331) Google Scholar ]. Recent meta-analysis with dabigatran was associated with an increased absolute risk of major acute cardiovascular events (MACE) [ [2] Uchino K. Hernandez A.V. Dabigatran association with higher risk of acute coronary events: meta-analysis of noninferiority randomized controlled trials. Arch. Intern. Med. 2012; 172: 397-402 Crossref PubMed Scopus (427) Google Scholar ]. It was suggested that a group-specific effect for OTI should be responsible [ [3] Artang R. Rome E. Nielsen J.D. Vidaillet H.J. Meta-analysis of randomized controlled trials on risk of myocardial infarction from the use of oral direct thrombin inhibitors. Am. J. Cardiol. 2013; 112: 1973-1979 Abstract Full Text Full Text PDF PubMed Scopus (85) Google Scholar ]. Nevertheless, observational studies such as Danish [ [4] Larsen T.B. Rasmussen L.H. Skjøth F. Due K.M. Callréus T. Rosenzweig M. Lip G.Y.H. Efficacy and safety of dabigatran etexilate and warfarin in “real-world” patients with atrial fibrillation: a prospective nationwide cohort study. J. Am. Coll. Cardiol. 2013; 61: 2264-2273 Crossref PubMed Scopus (386) Google Scholar ] and American [ [5] Graham D.J. Reichman M.E. Wernecke M. Zhang R. Southworth M.R. Levenson M. Sheu T.-C. Mott K. Goulding M.R. Houstoun M. Macurdy T.E. Worrall C. Kelman J.A. Cardiovascular, bleeding, and mortality risks in elderly Medicare patients treated with dabigatran or warfarin for nonvalvular atrial fibrillation. Circulation. 2015; 131: 157-164 Crossref PubMed Scopus (560) Google Scholar ] registries of dabigatran use have not confirmed these results. This discrepancy could be explained by the propensity matching [ [6] Sipahi I. Celik S. Akyol A. Dabigatran's “real-world” data about risk of myocardial infarction and gastrointestinal bleeding contradicts with randomized trials. J. Am. Coll. Cardiol. 2013; 62: 945-946 Crossref PubMed Scopus (13) Google Scholar ]." @default.
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• W2890713660 date "2019-01-01" @default.
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• W2890713660 title "The hidden side of oral thrombin inhibitors" @default.
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• W2890713660 doi "https://doi.org/10.1016/j.ijcard.2018.09.001" @default.
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