Dabigatran for Myocardial Injury in Non-Cardiac Surgery

In the MANAGE trial, the use of 110mg bid Dabigatran reduced the incidence of major vascular complications (without an increase in bleeding) after myocardial injury within 35 days of non-cardiac surgery. The difference wasn’t huge and the trial stopped early, and discontinuance rates of Dabigatran were high. The myocardial injury consisted of isolated Troponin elevations in 80% of cases. Low enrolment and change of primary endpoint were further limitations. So the question of monitoring Troponin levels continues as interventions are needed and this study is not overwhelmingly convincing in lowering death from MI, Stroke and other vascular complications.

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