Dabigatran Ester Clinical Application Proposal Released

In recent years, new types of oral anticoagulants have been more and more widely used in clinical practice in China, but there are no relevant guidelines or consensus in China to regulate the clinical use of new oral anticoagulants.

Recently, Professor Hu Dayi from the Heart Center of People’s Hospital of Peking University, Professor Ma Changsheng of Beijing Anzhen Hospital, Capital Medical University, and Dabiga, a famous doctor of cardiovascular disease, cerebrovascular disease, geriatrics, and hematology experts from across the country. The clinical application of group esters in the prevention of stroke in patients with non-valvular atrial fibrillation was published in the Chinese Journal of Cardiovascular Disease a few days ago, and has taken an important step in regulating the use of new oral anticoagulants.

The "Proposal" provides clinical doctors with detailed and practical clinical guidance programs, which helps clinicians to use dabigatran in a timely, correct, and standardized manner to improve the long-term prognosis of AF patients.

Ischemic stroke (stroke) is the most serious complication of atrial fibrillation. Prevention of stroke is an important part of the comprehensive management of atrial fibrillation. The "Recommendation" describes the internationally important clinical research on dabigatran etexilate, namely the efficacy and safety of dabigatran etexilate in patients with non-valvular atrial fibrillation. A randomized evaluation study of long-term anticoagulant therapy (RE-LY) . The study had 541 patients from China.

The results showed that the risk of stroke/systemic embolism was significantly reduced by 35% in dabigatran etexilate compared with the well-controlled warfarin group, and the risk of ischemic stroke, intracranial hemorrhage, and life-threatening hemorrhage was also higher than that of warfarin. Lin significantly decreased, and the risk of major bleeding was comparable; while the dabigatran etexilate 110 mg group had the same risk of stroke/systemic embolism as warfarin, with various bleeding risks significantly lower than warfarin.

The "Recommendations" indicate that dabigatran etexilate can be used for the prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation with CHADS2 score ≥1, such as when switching from warfarin to dabigatran etexilate. Warfarin is discontinued and dabigatran etexilate can be given immediately when the INR is <2.0. The "Proposal" also gives specific treatment measures and countermeasures for regular monitoring of medications and common clinical problems such as missing medications, excess and bleeding, and gastrointestinal adverse reactions.