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Invited Commentary
July 25, 2011

New Anticoagulant Drugs Among Elderly Patients Is Caution Necessary?Comment on “The Use of Dabigatran in Elderly Patients”

Author Affiliations

Author Affiliations: Department of Geriatrics and Rehabilitation, Hadassah Hebrew-University Medical Center, and Hebrew University Hadassah Medical School Mount Scopus, Jerusalem, Israel.

Arch Intern Med. 2011;171(14):1287-1288. doi:10.1001/archinternmed.2011.308

The mainstay of long-term oral anticoagulant therapy for more than half a century has been warfarin, and currently more than 1.5 million people in the United States take it every day. All this seems poised to change. The US Food and Drug Administration (FDA) recently widened their approval of dabigatran, a direct reversible thrombin inhibitor, to include its indication for stroke prevention among patients with atrial fibrillation (AF). This decision came in the wake of the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY)1,2 trial, comparing warfarin with dabigatran. The competitor will clearly challenge the use of our old, tried and usually-to-be-trusted friend, warfarin.