Dr. JS Hiremath: Drug Talk: Anticoagulation And STEMI
After 55 long years comes a new generation of anticoagulation drugs with many advantages over the old ones.
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Dr. JS Hiremath
Senior Interventional Cardiologist
Hall Clinic, Pune Ruby
What is so new about the new generation of anticoagulation drugs? No side effects or
reaction with other drugs, no INR monitoring and easy management are just the top-of-
the list advantages of these new drugs over the age-old heparin and warfarin, says Dr. JS
Hiremath in an interview with Dr. Manish Verma.
“Atrial fibrillation, venous thromboembolism, pulmonary embolism are a few heart
diseases which require use of anticoagulation drugs.”
“While Dabigatran , rivaroxaban, apixaban and edoxaban, all new anticoagulation drugs,
have done well in the trials, there would be preference for one drug over another in
“For instance, rivaroxaban or apixaban would be the best choice for renal dysfunction
while Dabigatran 150 mg for stroke prevention.”
Dr. Hiremath cites ‘people living longer’ as a reason for more incidence of atrial
fibrillation, a condition in which heart beats out of rhythm.
“For patients of STEMI, ACE inhibitors, specifically ramipril remains the drug of choice.
And in specific cases of intractable cough where ramipril cannot be used, which is the
case with 15-20% patients, valsartan- an ARB can be used.”