Document Detail


Dabigatran attenuates thrombin generation to a lesser extent than warfarin: could this explain their differential effects on intracranial hemorrhage and myocardial infarction?
MedLine Citation:
PMID:  23242974     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Compared with warfarin, dabigatran is associated with less intracranial hemorrhage, but an increased risk of myocardial infarction. To explore these phenomena, we compared their effects on thrombin generation. Thrombin generation in plasma from 10 patients taking therapeutic doses of warfarin (mean INR 2.6) was compared with that in plasma containing 250 ng/mL dabigatran. Although lag times were similar when thrombin generation was induced by recalcification or with a range of tissue factor concentrations, there was a greater reduction in peak thrombin generation and endogenous thrombin potential in plasma from warfarin-treated patients than in dabigatran-containing plasma. Similar results were obtained when thrombin generation was determined in plasma samples from 18 warfarin or 36 dabigatran treated patients entered into the RE-LY trial. Warfarin suppresses thrombin generation more efficiently than dabigatran. Greater suppression of normal hemostatic mechanisms in the brain and pathological thrombosis at sites of atherosclerotic plaque disruption may explain the higher rate of intracranial bleeding and lower rate of myocardial infarction with warfarin compared with dabigatran.
Authors:
Brian Dale; John W Eikelboom; Jeffrey I Weitz; Ed Young; Jeremy S Paikin; Michiel Coppens; Richard P Whitlock; Stuart J Connolly; Jeffrey S Ginsberg; Jack Hirsh
Related Documents :
10695464 - Transvenous parasympathetic nerve stimulation in the inferior vena cava and atrioventri...
8454254 - Modern concepts of atrial fibrillation.
18373664 - Prevalence and characteristics of continuous electrical activity in patients with parox...
10437314 - Main tributaries of the coronary sinus in the adult human heart.
22011774 - The extent of early left ventricular reverse remodelling is related to midterm outcomes...
7124614 - Intracoronary thrombolysis in syndromes of unstable ischemia: angiographic and clinical...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-16
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  -     ISSN:  1573-742X     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Maintaining a minimally invasive approach-vascular closure after trans-catheter aortic valve interve...
Next Document:  Acromioclavicular joint separations.