This purpose of this post is to clarify misstatements made in a recent New York Times article about the anticoagulant drug dabigatran (Pradaxa). The piece had three major inaccuracies, plus one thought-error from a cardiology leader. I write these words because the most valuable tool in the treatment of AF is knowledge. Getting it right […]
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Let’s talk about the new anticoagulants. Two recent studies involving dabigatran (Pradaxa) have shed new light on an important topic for patients with atrial fibrillation: the risk of bleeding versus the risk of stroke. Dabigatran and rivaroxaban (and soon, apixaban) have been approved for the prevention of stroke in patients with non-valvular atrial fibrillation (AF). […]
There was good news today in the atrial fibrillation world. Though no surprise to heart rhythm doctors, an FDA investigation reveals no evidence that new cases of bleeding are any higher with dabigatran (Pradaxa) than with warfarin. The full statement from the FDA is here. The assessment was undertaken because after approval of the novel […]
There was big news this week on the much-anticipated, but yet-to-be-evaluated novel blood thinner, apixaban (Eliquis). The FDA wants more information from the ARISTOTLE trial. They have inquired about “data management and verification.” That sounds serious. I made some comments about apixaban over at Trials and Fibrillations on theHeart.org. Here’s the mystery: Apixaban boasts incredibly […]
The good news: Patients with heart disease have enjoyed great advances in stroke and heart attack prevention in the last few years. The bad news: most of these advances have involved novel new blood-thinning drugs. The idea of blood thinners is quite simple: Heart attacks and strokes most often stem from clotted blood. The same […]
I am grateful that influential physician and social media leader, Dr. Kevin Pho (@KevinMD), re-posted my recent dabigatran comments. As is often the case with these new drugs, a spirited conversation ensued. Head over to KevinMD and take a look at my answers to some valid issues with the drug. Also, there’s a ton of […]
The safety of AF ablation depends greatly on the adequacy of blood thinning. AF ablation is no cardioversion. The choices of blood thinning regimens include either warfarin or dabigatran (Pradaxa)–and soon perhaps rivaroxaban or apixaban. The advantages of warfarin include the ability to confirm the level of thinness and its long-acting properties lessen after-procedure gaps […]
It’s crazy out there in blood thinner land. The novel blood thinning drug for patients with atrial fibrillation, Dabigatran (Pradaxa) cannot get a break. It’s all over the TV: Pradaxa = Bad Drug. Look at this image: Today, on the prestigious heart news site, theHeart.org, an insignificant 113-patient study presented as a poster at a […]
It’s well known that the new blood thinner, dabigatran (Pradaxa) can cause stomach pain and reflux symptoms. It occurs in slightly more than one in ten patients who start the drug. Yesterday, I learned of another potential gastrointestinal adverse effect of the new drug. A GI colleague called me about a patient taking dabigatran (Pradaxa) […]
My friend Bill is an ER doctor and a bike racer. He’s like me in that he has rediscovered the beauty of being a learner. His most recent area of inquiry is the blood clotting cascade and the use of reversal agents for the novel new blood thinners, (dabigatran, rivaroxaban and the soon to be […]
Doctors that treat atrial fibrillation (AF) are getting close to celebrating the one-year anniversary of having a substitute for warfarin. As an early adopter of the novel new blood-thinner, I would like to share some (almost) one year-old observations on dabigatran (Pradaxa). First, the science behind dabigatran is stellar. The landmark RE-LY trial studied 18,000 […]