Idarucizumab before reperfusion therapy in stroke patients on dabigatran: No more cold sweat

Abstract

According to the World Health Organization, during the next few decades, the burden of cardiovascular and cerebrovascular diseases, the 2 leading causes of death globally, will increase further as the world population ages. Approximately one-fourth to one-third of people will die of acute vascular diseases.(1) Thus, primary and secondary antithrombotic prevention plays a key role in reducing this burden. Prescription of oral anticoagulants has increased in recent years,(2) with at least 4 new direct oral anticoagulants (DOACs) emerging as alternatives to warfarin in different clinical scenarios. Compared to warfarin, DOACs have reduced risk of major bleeding, especially intracranial hemorrhages. Therefore, DOACs have become the first-line treatment for stroke prevention in patients with nonvalvular atrial fibrillation.