Neurology, Neuropsychiatry, Psychosomatics

Advanced search

Dabigatran etexilate for nonvalvular atrial fibrillation in real practice and promises for its use to prevent stroke

Full Text:


The capabilities of antithrombotic therapy to prevent thromboembolic events in nonvalvular atrial fibrillation (AF) are substantially extended after designing and clinically introducing new oral anticoagulants, one of which is dabigatran. A wealth of world clinical experience with dabigatran has confirmed its efficacy and safety provided that all recommendations for dosage regimens are followed. The universal properties of the drug can hope that the indications for its use will be extended and will not be confined to the prevention and treatment of venous and atrial thromboses and thromboembolisms. Whether dabigatran may be used in acute myocardial infarction and coronary stenting in the presence of nonvalvular AF, left ventricular thrombosis, and cardiomyopathies is being considered today.

About the Author

A.V. Fonyakin
Neurology Research Center, Russian Academy of Medical Sciences, Moscow
Russian Federation


1. Feinberg WM, Blackshear JL, Laupasic A, et al. Prevalence, age distribution and gender of patients with atrial fibrillation: analysis and implication. Arch Intern Med. 1995;155(5):469–73. DOI:

2. Go AS, Hylek EM, Philips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285(18):2370–5. DOI:

3. Naccarelli GV, Varker H, Lin J, Schulman KL. Increasing prevalence of atrial fibrillation and flutter in the United States.

4. Am J Cardiol. 2009;104(11):1534–9. DOI: 2009.07.022.

5. Wolf PA, Abbot RD, Kannel WB. Atrial fibrillation: a major contributor to stroke in the elderly: the Framingham Study. Arch Intern Med. 1987;147(9):1561–4. DOI:

6. Диагностика и лечение фибрилляции предсердий. Рекомендации РКО, ВНОА и АССХ. 2012. 112 с. [Diagnostika i lechenie fibrillyatsii predserdii. Rekomendatsii RKO, VNOA i ASSKh. [Diagnostics and treatment of fibrillation of auricles. PKO, BHOA and ACCX recommendations]. 2012. 112 p.

7. January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014 Mar 28; pii: S0735-1097(14)01739-2. DOI:10.1016/j.jacc.2014.03.021.

8. Hart RG, Pearce LA, Aguilar MI. Metaanalysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial

9. fibrillation. Ann Intern Med. 2007;146(12):857–67. DOI:

10. Samsa GP, Matchar DB, Goldstein LB, et al. Quality of anticoagulation management among patients with atrial fibrillation: results of a review of medical records from 2 communities. Arch Intern Med. 2000;160(7):967–73. DOI:

11. Baker W, Cios D, Sander S, Coleman CI. Meta-analysis to assess the quality of warfarin control in atrial fibrillation patients in the

12. United States. J Manag Care Pharm. 2009;15(3):244–52.

13. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361(12):1139–51. DOI:

14. Парфенов ВА, Вербицкая СВ. Новые возможности профилактики инсульта при фибрилляции предсердий. Неврология,

15. нейропсихиатрия, психосоматика. 2012;(1):36–42. [Parfenov VA, Verbitskaya SV. New possibilities in the prevention of stroke in atrial fibrillation. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(1):36–42. (In Russ.)]. DOI:

16. Фонякин АВ, Гераскина ЛА. Новая эра антикоагулянтной терапии в профилактике инсульта при неревматической фибрилляции предсердий. Неврология, нейропсихиатрия, психосоматика. 2012;(3):15–9. [Fonyakin AV, Geraskina LA. A new era of anticoagulant therapy in the prevention of stroke in non-rheumatic atrial fibrillation. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;(3):15–9. (In Russ.)]. DOI:

17. European Medicines Agency updates on safety of Pradaxa. Available from:

18. Pradaxa (dabigatran etexilate mesilate). EPAR summary for the public. Available from: http://www.ema.europa./eu/docs/en_GB/document_library/EPAR_Summary_for_the_public/human/000829/WC500041060.pdf. Date of access: 08.12.2011.

19. Явелов ИС. Применение дабигатрана этексилата для профилактики кардиоэмболических осложнений при неклапанной фибрилляции предсердий: как сделать вмешательство наиболее эффективным и безопасным. Рациональная фармакотерапия в кардиологии. 2011;7(6):757–64. [Yavelov IS. Application of dabigatran etirsilat for prevention the kardioembolicheskikh of complications at not valvate fibrillation of auricles: how to make intervention by the most effective and safe. Ratsional'naya farmakoterapiya v kardiologii. 2011;7(6):757–64. (In Russ.)]

20. Friberg L, Rosenqvist M, Lip GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation Cohort study. Eur Heart J. 2012;33(12):1500–10. DOI:

21. Wouters H, Thijs V, Annemans L. Costeffectiveness of dabigatran etexilate in the prevention of stroke and systemic embolism in patients with atrial fibrillation in Belgium. J of Med Economic. 2013;16(3):407–14. DOI:10.3111/13696998.2013.766200.

22. Sorensen R, Gislason G, Torp-Pedersen C, et al. Dabigatran use in Danish atrial fibrillation patients in 2001: a nationwide study. BMJ. Open 2013;3(5). pii: e002758. DOI:10.1136/bmjopen-2013-002758.

23. Banerjee A, Lane DA, Torp-Pedersen C, Lip GY. Net clinical benefit of new oral anticoagulants (dabigatran, rivaroxaban, apixaban) vs. no treatment in a ‘real world’ atrial fibrillation population: a modeling analysis based on a nationwide cohort study. Thromb Haemost. 2012;107(3):584–9. DOI: 10.1160/TH11-11-0784.

24. Connoly SJ, Walentin L, Ezekowitz MD, et al. The long-term multicenter observation study of dabigatran treatment in patients with atrial fibrillation (RELY-ABLE) study. Circulation. 2013;128(3):237–43. DOI:10.1161/CIRCULATIONAHA.112.001139. Epub 2013 Jun 14.

25. Heidbuchel H, Verhamme P, Alings M, et al. European Geart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace. 2013;15(5):625–51. DOI:

26. Lamberts M, Olesen JB, Ruwald MH, et al. Bleeding after initiation of multiple antithrombotic drugs, including triple therapy, in atrial fibrillation patients following myocardial infarction and coronary intervention: a nationwide cohort study. Circulation. 2012;126(10):1185–93. DOI:

27. Freek WA. Verheugt. Antithrombotic therapy during and after percutaneous coronary intervention in patients with atrial fibrillation. Circulation. 2013;128(18):2058–61. DOI:10.1161/CIRCULATIONAHA.113.002250.

28. Oldgren J, Budaj A, Granger ChB, et al. Dabigatran vs placebo in patients with acute coronary syndromes on dual antiplatelet therapy: a randomized, double-blind, phase II trial. Eur Heart J. 2011;32(22):2781–9. DOI:

29. Eikelboom JW, Wallentin L, Connolly SJ, et al. Risk of bleeding with 2 doses of dabigatran compared with warfarin in older and younger patients with atrial fibrillation: an analysis of the randomized evaluation of long-term anticoagulant

30. therapy (RE-LY) trial. Circulation. 2011;123(21):2363–72. DOI:

31. Huber K, Connolly SJ, Kher A, et al. Practical use of dabigatran etexilate for Stroke prevention in atrial fibrillation. Int J Clin Pract. 2013;67(6):516–26. DOI: 10.1111/ijcp.12147.

32. Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack. A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

33. Stroke. 2014 May 1. DOI: 10.1161/STR.0000000000000024.

34. Гераскина ЛА. Кардиоэмболический инсульт: многообразие причин и современные подходы к профилактике. Неврология, нейропсихиатрия, психосоматика. 2013;(4):60–5. [Geraskina LA. Cardioembolic stroke: a variety of causes and current approaches to its prevention. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2013;(4):60–5. (In Russ.)]. DOI:

For citation:

Fonyakin A. Dabigatran etexilate for nonvalvular atrial fibrillation in real practice and promises for its use to prevent stroke. Neurology, Neuropsychiatry, Psychosomatics. 2014;6(2):44-50. (In Russ.)

Views: 445

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)