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Newer Blood Thinners May Outperform Old Standbys
Date:11/18/2009

Studies found warfarin, Plavix bested by latest anti-clotting alternatives

WEDNESDAY, Nov. 18 (HealthDay News) -- After years of little progress, three new trials suggest that the latest generation of blood thinners may outperform the old standbys warfarin and clopidogrel (Plavix).

In one study, dabigatran etexilate (marketed as Pradax in Canada and Pradaxa in Europe; it is not yet approved in the United States) proved to be safe in preventing blood clots when patients were treated for acute coronary syndrome, a cluster of symptoms that might indicate a heart attack.

"Dabigatran seems to be safe on top of dual antiplatelet therapy [meaning aspirin and Plavix]," said study author Dr. Jonas Oldgren, chief physician in the department of cardiology at Uppsala University Hospital in Uppsala, Sweden. "It has already been shown to have superior efficacy compared with warfarin."

A previous trial had demonstrated that dabigatran outperformed warfarin in preventing strokes in patients with atrial fibrillation.

The current trial, to be presented Wednesday at the American Heart Association's annual meeting in Orlando, Fla., also saw a reduction in mortality, nonfatal heart attack and stroke, although it was not specifically designed to look at efficacy.

"Dabigatran appears to be superior to warfarin in terms of safety and more effective as well. This is the first alternative to warfarin that could signal a changing of the guard," said Dr. Bernard Gersh, a professor of medicine at the Mayo Clinic College of Medicine in Rochester, Minn. "I think there are still questions that need to be answered but it's fair to say that warfarin has been around for many, many years and everybody hates warfarin. Patients hate warfarin. Doctors hate warfarin. It's not the most convenient drug, but it's effective and it is cheap."

The trial involved more than 18,000 patients in 24 countries with acute coronary syndrom
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