, Volume 26, Issue 5, pp 361-364
Date: 18 Sep 2012

Dabigatran etexilate: Another Double-Edged Drug?

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The important limitations and drawbacks of classical parenteral (heparin, low molecular weight heparin and fondaparinux) or oral (vitamin K antagonists) anticoagulants have prompted the development of novel agents that directly inhibit either thrombin or activated factor X (FXa), two key serine proteases in the coagulation cascade. Currently, two oral anticoagulants (dabigatran etexilate, a direct thrombin inhibitor, and rivaroxaban, an inhibitor of FXa) are approved in more than 70 countries for prevention of venous thromboembolism in patients undergoing elective hip or knee arthroplasty, and in the United States and Europe for prophylaxis of stroke and systemic embolism in patients with non-valvular atrial fibrillation [1, 2].

Thrombin and FXa are classically known by their roles in the coagulation cascade, but in addition to their functions in hemostasis in recent years it has been increasingly recognized that they may exert pleiotropic effects in several cell types, acting as signal ...