Warfarin Vs dabigatran Essay Example | Topics and Well Written Essays - 1250 words

Warfarin Vs dabigatran - Essay ExampleAny discrepancy in dieting mediated intensity of vitamin K, directly influences the efficacy and dose dependency of Warfarin for the patient. It is essential to determine appropriate therapeutic dosages on individual basis by means of standardized clotting test (international normalized ratio INR). Although, Warfarin potentially diminishes the risk of stroke in AF patients by 68%, patient compliance with manipulation (time in therapeutic range TTR) is a noteworthy predicament because of the essential periodic supervision of dose efficacy and the risk of major discharge events (Ezekowitz, 2007). On the contrary, Dabigatran does not entail labor and time intensive monitoring and therefore expected to provide enhanced patient compliance over Warfarin. Atrial fibrillation is symptomless and generally not life-threatening. It augments the risk of stroke as well as general embolisms as the upper chambers of the heart begin to beat irregularly, imp airing the efficiency of blood flow. Symptoms found to be associated encompass rapid heart rate, palpitation, shortness of breath, dizziness, faint or fatigue. Reduced flow of blood results in blood pooling in the heart chambers which may culminate into clot formation. When such clots enter the brain it results in stroke, it is therefore essential for physicians to prescribe anticoagulants to prevent formation of clots. The prevalence of AF in the United States display augmentation from 10% for individuals above 80 (Centers for Disease Control and Prevention CDC, 2003). Deaths associated to AF affect 1 in 4000 cases per year, of these, 84% cases are inform to be above 75. Warfarin was drug of choice for past decades as an effective oral anticoagulant to prevent and treat thromboembolism. Over the years researchers were ceaselessly trying to relieve patients from troubles related to diet and drug interactions. Three randomized, controlled trials are available on the safety and ef ficacy of Dabigatran, they are summarized below- Atrial fibrillation patients frequently adjoin from coronary artery disease, which is the focus of a Dabigatran phase II clinical trial, to establish its safety in combination with aspirin (Ezekowitz et al., 2007). Three Dabigatran doses (50, 150, and 300 mg) were administered twice daily to patients for 12 weeks, unaided or in combination with 81 or 325 mg aspirin, thereby generating nine experimental groups. The patients treated with Warfarin (INR = 2.0-3.0) were employ as a control. The primary outcome of concern was bleeding events encompassing major (6% increase, p 0.02) or all sorts of bleeding events (26% increase, p = 0.0003), that was reported in patients treated with 300 mg Dabigatran twice a day along with aspirin. On the other hand, 50 mg Dabigatran was less likely to cause bleeding as compared to other conditions (15% increase vs. 300 mg p = 0.0002 11% increase vs. 150 mg p = 0.01 11% increase vs. Warfarin, p = 0.044) . On the contrary, two embolisms reported in the study were from the cases taking 50 mg Dabigatran twice daily, unaided or accompanied by 81 mg aspirin. On the other hand result indicates that 50 mg Dabigatran, with or without 81 mg aspirin, does not accomplish successful shielding against stroke or systemic embolisms. This possibility was sustained by finding