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Dabigatran is an oral direct thrombin inhibitor that is effective in preventing venous thromboembolism after orthopedic surgery (JW Oncol Hematol Dec 18 2007). A prodrug that is rapidly converted to the active agent, dabigatran has a half-life of 14 to 17 hours and is primarily excreted by the kidneys. Its advantage over warfarin is that it does not require monitoring.
To examine the effectiveness and safety of dabigatran for management of atrial fibrillation, an international team of investigators, with manufacturer support, randomized more than 18,000 patients who were at risk for stroke to low-dose dabigatran (110 mg twice daily), high-dose dabigatran (150 mg twice daily), or adjusted-dose warfarin (international normalized ratio, 2–3); a…