Dabigatran for prophylaxis of thromboembolic events in patients with atrial fibrillation

Joachim R Ehrlich1, Matthias Hammw hner3, Andreas Goette2,31Deutsche Klinik für Diagnostik, Department of Cardiology, Wiesbaden, 2Working Group, Molecular Electrophysiology, University Hospital Magdeburg, 3Department of Cardiology and Intensive Care Medicine, St Vincenz-Hospital Paderborn, GermanyAbstract: Atrial fibrillation is the most common clinically relevant cardiac arrhythmia. Prevalence and incidence rates are constantly rising with advancing population age. A severe complication of untreated atrial fibrillation is thrombus formation in the left atrial appendage with consecutive peripheral thromboembolism. Thus, atrial fibrillation is a major contributor to thromboembolic events, especially in the older population. Depending on the CHADS2 risk score for thromboembolic events, oral anticoagulation therapy with vitamin K antagonists is currently the treatment of choice for the prevention of thromboembolism, including apoplectic strokes. However, due to the drawbacks of current anticoagulation therapy, new substances for oral anticoagulation therapy are currently being evaluated in various clinical studies. This article will provide an up to date overview of orally active compounds for the future treatment of atrial fibrillation using the direct thrombin inhibitor, dabigatran.Keywords: atrial fibrillation, anticoagulation, pathophysiology, pharmacology, stroke