The association of direct thrombin inhibitor anticoagulants with cardiac thromboses

Area of Science:

• Cardiology
• Pharmacology
• Thrombosis Research

Background:

• Direct thrombin inhibitors (anti-factor IIa) are established anticoagulants for cardiac thromboembolism and venous thromboembolism (VTE).
• Previous studies indicate a potential association between these agents and adverse thrombotic events.

Purpose of the Study:

• To compare the frequency of thrombosis on abnormal cardiac endothelium between direct thrombin inhibitors and indirect anticoagulants.
• To evaluate the class effect of direct thrombin inhibitors regarding thrombotic complications.

Main Methods:

• Head-to-head comparison of anticoagulant therapies.
• Analysis of studies with sufficient patient numbers and duration.

Main Results:

• Direct thrombin inhibitors were associated with a significantly increased frequency of thrombosis on abnormal cardiac endothelium.
• This association was observed when compared to indirectly acting therapeutic anticoagulants.

Conclusions:

• The findings suggest a class effect of direct thrombin inhibitors leading to increased thrombosis risk.
• Prescribing alternative anticoagulants to direct thrombin inhibitors is warranted for patients with abnormal cardiac endothelium.