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Randomised clinical trial
Novel anticoagulants in patients with mechanical heart valves
  1. Ralph A H Stewart
  1. Department of Cardiology, University of Auckland, Auckland City Hospital, Auckland, New Zealand
  1. Correspondence to : Dr Ralph A H Stewart, Department of Cardiology, Auckland City Hospital, Level 3, Building 32, Private Bag 92024, Victoria Street West, Auckland 1142, New Zealand; rstewart{at}adhb.govt.nz

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Context

Novel anticoagulants (including the direct thrombin inhibitor dabigatran etixilate) and oral factor Xa inhibitors have similar or superior efficacy and safety to warfarin for reducing thromboembolic stroke in patients with atrial fibrillation, and for prevention of deep venous thrombosis. Eikelboom and colleagues set out to examine whether these novel anticoagulants could be used as an alternative to warfarin in patients with mechanical heart valves.

Methods

RE-ALIGN was a randomised, open-label phase 2 trial with blinded adjudication of endpoints. Patients who had undergone aortic or mitral …

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