A proposal for dose-adjustment of dabigatran etexilate in atrial fibrillation guided by thrombin time

Paul Chin, Daniel Wright, David Patterson, Matthew Doogue, Evan Begg

    Research output: Contribution to journalArticle

    22 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)599-609
    Number of pages11
    JournalBritish Journal of Clinical Pharmacology
    Volume78
    Issue number3
    DOIs
    Publication statusPublished - Sep 2014

    Keywords

    • atrial fibrillation
    • blood coagulation
    • dabigatran
    • dosing
    • monitoring

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