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Direct thrombin inhibitors
Author(s) -
Lee Catherine J.,
Ansell Jack E.
Publication year - 2011
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/j.1365-2125.2011.03916.x
Subject(s) - discovery and development of direct thrombin inhibitors , lepirudin , bivalirudin , argatroban , medicine , dabigatran , direct thrombin inhibitor , thrombin , antithrombins , hirudin , ximelagatran , heparin , intensive care medicine , warfarin , atrial fibrillation , anticoagulant , pharmacology , antithrombin , percutaneous coronary intervention , myocardial infarction , platelet
Heparins and vitamin K antagonists have been the primary agents used for anticoagulation in certain cardiovascular and thromboembolic diseases for over 50 years. However, they can be difficult to administer and are fraught with limitations. In response to the need for new anticoagulants, direct thrombin inhibitors (DTIs) have been developed and investigated for their utility in prophylaxis and treatment of venous thromboembolism (VTE), heparin‐induced thrombocytopenia (HIT), acute coronary syndromes (ACS), secondary prevention of coronary events after ACS, and nonvalvular atrial fibrillation. Currently, four parenteral direct inhibitors of thrombin activity are FDA‐approved in North America: lepirudin, desirudin, bivalirudin and argatroban. Of the new oral DTIs, dabigatran etexilate is the most studied and promising of these agents. This review discusses the clinical indications and efficacy of these direct thrombin inhibitors as well as future directions in anticoagulant therapy.