February 9, 2005

Ximelagatran—Promises and Concerns

Author Affiliations

Author Affiliation: Vascular Research Laboratory, Beth Israel Deaconess Hospital Medical Center, Boston, Mass.

JAMA. 2005;293(6):736-739. doi:10.1001/jama.293.6.736

Vitamin K (“Koagulation”) antagonists have been the sole oral anticoagulants available for 60 years, ever since Link1 identified the components in spoiled sweet clover responsible for bleeding in cattle. Originally developed as a rat poison, vitamin K antagonists such as warfarin are used successfully for the prevention of venous and arterial thromboembolism for a wide range of clinical indications, including atrial fibrillation (AF), venous thromboembolism (VTE), coronary artery disease, some orthopedic procedures, and congenital or acquired thrombophilia. Since both age and obesity increase the risk of atrial fibrillation2 and VTE, the need for anticoagulants is increasing.

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