CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 10, November 2012
AFRICA
573
One of the highlights of the second
joint meeting was that it extended past
the UK borders, with the participation
of other European PhD students and
cardiovascular researchers. The next UK–
SA (or UK–EU) workshop will be held in
France in two years’ time.
The event was funded by UCT and the European
Society for Cardiology, a European exchange
programme (PROMISE), and industrial partners
(
SANOFI, Abcam).
ROISIN KELLY-LAUBSCHER,
Department of Human Biology,
University of Cape Town, South Africa
GIDEON BURGER
Lasec, Cape Town, South Africa
NEIL DAVIES
Cardiovascular Research Unit,
University of Cape Town, South Africa
ANNA-MART ENGELBRECHT
Department of Physiological Sciences,
University of Stellenbosch, South Africa
KAREN SLIWA
SANDRINE LECOUR
Hatter Institute for Cardiovascular
Disease in Africa, University of Cape
Town, South Africa
HANS STRIJDOM
Division Medical Physiology, University
of Stellenbosch, South Africa
DEREK HAUSENLOY
Hatter Cardiovascular Institute,
University College, London, United
Kingdom
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Drug Trends in Cardiology
South Africa enters a new era in stroke prevention
Boehringer Ingelheim choseWorld Stroke
Day on 29 October to launch its novel
anticoagulant, Pradaxa (dabigatran) in
South Africa. It promises to revolutionise
stroke prevention in patients with atrial
fibrillation (AF).
Speaking at the launch, Dr Kevin
Ho, medical director of Boehringer
Ingelheim, said that AF affects one in four
individuals over the age of 40 years and
that the aging population worldwide will
see the number of AF sufferers double
in the next 30 years. AF increases the
risk of stroke (mainly ischaemic) five-
fold. Current therapies such as warfarin
and aspirin have limitations to their use.
Pradaxa promises to address unmet needs
consequent thereon.
According to Dr IWP Obel, an
electrophysiologist based at the Netcare
Milpark Hospital, Johannesburg, the
statistics are stark. ‘Without preventive
treatment, one in 20AF patients will suffer
a stroke. The condition is responsible for
nearly one-third of all strokes, and stroke
is the leading complication of AF.’
Aspirin offers insufficient protection
in high-risk patients and is associated with
limited stroke-risk reduction. Warfarin’s
narrow therapeutic window, many food–
drug and drug–drug interactions and slow
onset–offset of action hamper its use. It
requires regular coagulation monitoring,
a major issue for patients, and also carries
a high risk of inducing bleeding.
‘
This unpredictable response means
that it is both underused and wrongly
used’, he continued. ‘Only half of eligible
patients receive warfarin, and this is
especially the case in elderly patients
where AF is common. Most ischaemic
strokes occur in patients who are
inadequately anticoagulated.’
The goals of anticoagulation therapy
are to prevent ischaemic stroke and
minimise the risk of haemorrhagic stroke/
intracranial haemorrhage. ‘New agents
such as Pradaxa, which has a predictable
mode of action and does not require
monitoring, can help us achieve these
goals’, Dr Obel concluded.
J Aalbers
