Increased risk of myocardial infarction with dabigatran: Fact or fiction?

Ada F. Giglio, Eloisa Basile, Pasquale Santangeli, Luigi Di Biase, Francesco Trotta, Andrea Natale

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


Dabigatran is a direct, competitive inhibitor of thrombin recently approved for the prophylaxis of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. In some of the clinical trials evaluating the efficacy and safety of dabigatran in different clinical settings [i.e., prevention of venous thromboembolism (VTE) after orthopedic surgery, secondary prevention of VTE, and acute coronary syndromes (ACS)], a trend toward an increase in acute coronary events among patients receiving dabigatran has been reported, thus raising concerns of a possible relationship between dabigatran and myocardial infarction, especially in high-risk patients. However, as shown in our article, current evidence is inconclusive on this topic; more data are needed to detail this hypothetical association, and other considerations, such as the well-known protective effect of warfarin against ACS, should be taken into account as a possible explanation.

Original languageEnglish (US)
Pages (from-to)19-26
Number of pages8
JournalJournal of Cardiovascular Medicine
Issue number1
StatePublished - 2014
Externally publishedYes


  • atrial fibrillation
  • dabigatran
  • myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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