atrial fibrillation and stroke prevention - Continuing Medical ...
atrial fibrillation and stroke prevention - Continuing Medical ... atrial fibrillation and stroke prevention - Continuing Medical ...
Essentials in Primary Care Conference Wednesday, July 31, 2013 Warfarin first used Timeline of Antithrombotic Therapies for Atrial Fibrillation Unfractionated heparin for PE Efficacy of warfarin to prevent AF-related stroke demonstrated Fondaparinux, bivalirudin and argatroban approved LMWHs approved For VTE FDA rejects ximelagatran: possible liver toxicity FDA approves dabigatran Dabigatran and rivaroxaban Europe and Canada FDA approves rivaroxaban FDA approves apixaban 1950’s 1960 Early 1990’s Mid- 1990’s 2000-1 2004 2009 Oct 2010 Nov 2011 Dec 2012 XII Unfractionated Heparin XI IX Low Molecular Weight Heparin VIII X V II I Fibrin Clot Ericksson BI et al. Clinical Pharmacokinetics 2009;48:1-22 Anticoagulants FDA Approved* and In Development** VII New Oral Xa Inhibitors Rivaroxaban* Apixaban* Edoxaban** Warfarin New Oral IIa (Direct Thrombin) Inhibitor Dabigatran * Jan Basile, MD Atrial Fibrillation & Stroke Prevention
Essentials in Primary Care Conference Wednesday, July 31, 2013 Antithrombotic Therapies for AF • Warfarin 1960’s • Dabigatran (Pradaxa) September 2010 • Rivaroxaban (Xarelto) November 2011 • Apixaban (Eliquis) December 2012 RE-LY Dabigatran vs Warfarin for NV AF BASELINE CHARACTERISTICS • 18,311 subjects • Mean age = 72 • Previous long-term warfarin: 50% • 64% men • Mean CHADS 2 = 2.1 • ASA (
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Essentials in Primary Care Conference<br />
Wednesday, July 31, 2013<br />
Antithrombotic Therapies for AF<br />
• Warfarin 1960’s<br />
• Dabigatran (Pradaxa) September 2010<br />
• Rivaroxaban (Xarelto) November 2011<br />
• Apixaban (Eliquis) December 2012<br />
RE-LY<br />
Dabigatran vs Warfarin for NV AF<br />
BASELINE CHARACTERISTICS<br />
• 18,311 subjects<br />
• Mean age = 72<br />
• Previous long-term warfarin: 50%<br />
• 64% men<br />
• Mean CHADS 2 = 2.1<br />
• ASA (
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