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A proposal for dose‐adjustment of dabigatran etexilate in atrial fibrillation guided by thrombin time
Author(s) -
Chin Paul K. L.,
Wright Daniel F. B.,
Patterson David M.,
Doogue Matthew P.,
Begg Evan J.
Publication year - 2014
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.12364
Subject(s) - dabigatran , atrial fibrillation , medicine , rivaroxaban , coagulation , discovery and development of direct thrombin inhibitors , warfarin , cardiology , thrombin time , direct thrombin inhibitor , thrombin , oral anticoagulant , anticoagulant , pharmacology , anesthesia , partial thromboplastin time , platelet
Dabigatran is an oral anticoagulant that is increasingly used for atrial fibrillation ( AF ). Presently, many authorities state that routine laboratory coagulation monitoring is not required. However, data have recently been published demonstrating that higher trough plasma dabigatran concentrations are associated with lower thromboembolic and higher haemorrhagic event rates. Using these data, we simulate a range of AF patients with varying risks for these events and derive a target range of trough plasma dabigatran concentrations (30–130 μg l −1 ). Finally, we propose that a conventional screening coagulation assay, the thrombin time ( TT ), can be used to discern whether or not patients are within this range of dabigatran concentrations.