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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Anticoagulation for atrial fibrillation in the elderly
1The Zena and Michael A. Wiener Cardiovascular Institute, The Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Medical Center, Fifth Avenue at 100th Street, New York, NY 10029, USA. jonathan.halperin@msnyuhealth.org
The American Journal of Geriatric Cardiology
|March 24, 2005
Summary
Atrial fibrillation increases stroke risk, but new oral anticoagulants like ximelagatran show promise. Ximelagatran offers comparable stroke prevention to warfarin with reduced bleeding risk.
Area of Science:
- Cardiology
- Neurology
- Pharmacology
Background:
- Atrial fibrillation is a significant risk factor for stroke, especially in older populations.
- Antithrombotic therapy is proven to reduce stroke risk in patients with atrial fibrillation.
- Warfarin is effective but underutilized due to bleeding risks and monitoring needs.
Purpose of the Study:
- To evaluate the efficacy and safety of the oral direct thrombin inhibitor ximelagatran for stroke prevention in atrial fibrillation patients.
- To compare ximelagatran's performance against well-controlled warfarin therapy.
Main Methods:
- Two large clinical trials were conducted to investigate ximelagatran.
- Patients with atrial fibrillation received fixed-dose ximelagatran or adjusted-dose warfarin.
- Outcomes assessed included stroke prevention and bleeding events.
Main Results:
- Ximelagatran demonstrated comparable efficacy to warfarin in preventing stroke.
- Treatment with ximelagatran resulted in less bleeding compared to warfarin.
- Anticoagulation intensity did not require monitoring with ximelagatran.
Conclusions:
- Ximelagatran presents a viable, fixed-dose oral anticoagulant option for stroke prevention in atrial fibrillation.
- Its favorable safety profile, with reduced bleeding, makes it a potentially attractive alternative to warfarin.
- Further research on other emerging antithrombotics is ongoing but not yet sufficient for widespread clinical adoption.
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