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            <i>American Journal of Medicine</i>          </div>
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<h2>ACCF/AHA/HRS Focused Update Recommendations for Dabigatran</h2>
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<div class='figure_text' speaker='camm' figure='17'>
      
      
      
      
      
      
      <p style="">
 
US guidelines from the American College of Cardiology/American Heart Association/Heart Rhythm Society (ACCF/AHA/HRS<span class="GINGER_SOFATWARE_correct" grcontextid="):0" ginger_sofatware_markguid="b0f64ec7-b20a-4c41-a73d-13670a2b041a" ginger_sofatware_uiphraseguid="680eaee0-56b8-436f-b17f-b1c7a8b87e53">)</span><span class="ref_num">25]<br style=""></span>have expressed no preferences between a NOAC – in this case <span class="GINGER_SOFATWARE_spelling" ginger_sofatware_uiphraseguid="1a26ba4c-1e31-4657-8d55-fbd9f034b55a">dabigatran,</span> when these guidelines were written – and a vitamin K antagonist (<b>Figure 17</b>). &nbsp;The guideline specifies the patients for whom the therapy is recommended and specifically states that in patients with renal failure (creatinine clearance &lt;15 <span class="GINGER_SOFATWARE_correct" grcontextid="mL:0" ginger_sofatware_markguid="a05d3a75-c874-4451-89f8-21ac3befcfe5" ginger_sofatware_uiphraseguid="0a80ee42-4db7-479e-91a4-6c727707d271">mL</span>/min), advanced liver disease, or with significant valve disease, vitamin K antagonists are preferable to <span class="GINGER_SOFATWARE_noSuggestion GINGER_SOFATWARE_correct" grcontextid="dabigatran:1" ginger_sofatware_markguid="c1a49422-075a-47bf-9960-74d476040174" ginger_sofatware_uiphraseguid="0a80ee42-4db7-479e-91a4-6c727707d271">dabigatran</span>. &nbsp;<b>Camm J. <i>Am J <span class="GINGER_SOFATWARE_correct" grcontextid="Med:0" ginger_sofatware_markguid="3a393779-686a-4ce5-ba33-74625240ce6d" ginger_sofatware_uiphraseguid="1d55a6b3-3791-4e43-8e58-5c47faa42178">Med</span> </i>2013</b>; published on-line at http://education.amjmed.com/00000.<br class="aloha-end-br"></p>
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  <div class='figure_references' speaker='camm' figure='17'>
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  <h2>References</h2>
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    <span class="ref_num">[25]</span> Wann LS, Curtis AB, Ellenbogen KA, et al. 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (update on dabigatran): a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. <i>J Am Coll Cardiol</i>. 2011;57:1330-1337.  </p>
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