CARDIOVASCULAR JOURNAL OF AFRICA • Vol 22, No 5, September/October 2011
286
AFRICA
scientifically superior agents for South
African patients, due to lack of Medicines
Control Council (MCC) approval and
consequent non-reimbursement from
medical aid funders. The MCC should be
proactive in fast tracking the approval of
these highly beneficial drugs, which are
already internationally available; circum-
venting any consequent beguiled health-
care funding constraints.
While we are able to consider the use
of the 110-mg bid dabigatran dose ‘off
South African label/registration approv-
als’, there is greater benefit to be derived
from the 150-mg bid dose. Sooner MCC
approval of these medications would
facilitate the enhanced ischaemic stroke
protection especially associated with the
higher dibagatran dose, with fewer bleed-
ing complications, and with a 59% reduc-
tion in ischaemic stroke compared to
warfarin.
1.
Connolly SJ,
et al.
Dabigatran versus warfa-
rin in patients with atrial fibrillation.
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: 1139–1151.
2.
Connolly SJ, Ezekowitz Md, Yusuf S, Reilly
PA, Wallentin L. Newly identified events
in the RE-LY trial
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3.
Dans A,
et al
. Concomitant use of anti-
platelet therapy with dabigatran or warfarin
in the Randomized Evaluation of Long-
term Anticoagulation Therapy (RE-LY)
trial. Presented at the European Socity of
Cardiology Congress 2011, 28 August 2011.
4.
Reilly P,
et al
. Concomitant use of
P-glycoprotein inhibitors with dabigatran
or warfarin in the Randomised Evaluation
of Long-term Anticoagulation TherapY
(RE-LY) trial. Presented at the European
Society of Cardiolgy Congress 2011, 28
August 2011.
5.
Lip GY. The role of aspirin for stroke
prevention in atrial fibrillation.
Nat Rev
Cardiol
2011; e-pub DOI: 10.1038/nrca-
dio.2011.112.
6.
Eikelboom JW, Wallentin L, Connolly SJ,
Ezekowitz M, Healy JS,
et al
. Risk of
bleeding with 2 doses of dabigatran versus
warfarin in older and younger patients
with atrial fibrillation – an analysis of the
randomised evaultion of RE-LY trial circu-
lation.
Circulation
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(21): 2363–2372.
Epub 16 May 2011.
It's the
shell that
makes
safer.
R
Safety-Coated
R
81mg
The ORIGINAL low dose aspirin
for optimum cardio-protection
Hp
Each tablet contains Aspirin 81mg. Reg.No.: 29/2.7/0767
Pharmafrica (Pty) Ltd, 33 Hulbert Road, New Centre, Johannesburg 2001
Under licence from Goldshield Pharmaceuticals Ltd. U.K.
