Direct Oral Anticoagulants and Myocardial Infarction: The Dust Is Settling


In the Randomized Evaluation of Long-Term Anticoagulation Therapy® (RE-LY®) trial, dabigatran showed a non-significant increase in the risk of myocardial infarction (MI) when compared with warfarin, leading to a series of discussions on the effect of dabigatran on MI.

This editorial refers to an article by Lee et al, in the same issue of J Am Coll Cardiol, that reported the results of a Danish nationwide cohort study involving patients with atrial fibrillation treated with direct oral anticoagulants (DOACs) for stroke prevention. The findings suggest a significant decrease in the risk of MI by DOACs when compared with warfarin.

The authors suggest that the findings from the large Danish registry study will help address concerns about the risk of MI in patients receiving DOACs, including those with a history of coronary artery disease and prior MI.

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Hohnloser SH, Eikelboom JW. J Am Coll Cardiol 2018;72:27–8.