"Dabigatran seems to be safe on top of dual antiplatelet therapy [meaning aspirin and Plavix]," study author Dr. Jonas Oldgren, chief physician in the department of cardiology at Uppsala University Hospital in Uppsala, Sweden, said at the time. "It has already been shown to have superior efficacy compared with warfarin."
And another trial, also presented at the AHA meeting, demonstrated that dabigatran outperformed warfarin in preventing strokes in patients with atrial fibrillation.
"Dabigatran appears to be superior to warfarin in terms of safety and more effective as well. This is the first alternative to warfarin that could signal a changing of the guard," Dr. Bernard Gersh, a professor of medicine at the Mayo Clinic College of Medicine in Rochester, Minn, said during the heart association conference. "I think there are still questions that need to be answered, but it's fair to say that warfarin has been around for many, many years and everybody hates warfarin. Patients hate warfarin. Doctors hate warfarin. It's not the most convenient drug, but it's effective and it is cheap."
"It's premature to say that a drug like dabigatran will take the place of warfarin," Gersh added. "There will be a lot of discussion about cost and convenience. It's a twice-daily dose and there are some questions about a possible higher rate of heart attack. I don't think this is truly resolved yet, but I think we can say that for the first time we have seen a drug that certainly has the potential to be an alternative to warfarin, and maybe even superior."
Visit the American Heart Association for more on blood thinners.
SOURCES: Dec. 6, 2009, New England Journal of Medicine, online; Bernard Gersh, M.D., professor, medicine, Mayo Clinic College of Medicine, Rochester, Minn.; Nov. 18, 2009, news conference with Jonas Oldgren, M.D., chief physician, cardiology, Uppsala University Hospital, Uppsala, Sweden; Nov. 18, 2009, presentations, American Heart Association annual meeting, Orlando, Fla.