JAMA Network | Archives of Internal Medicine | Dabigatran Association With Higher Risk of Acute Coronary EventsMeta-analysis of Noninferiority Randomized Controlled Trials
We do not know the pharmacologic mechanism that may result in dabigatran increasing the risk of MI or ACS.
The development of another direct thrombin inhibitor, ximelagatran, was halted when a higher risk of increase in hepatic transaminase levels was observed.
Although the anticoagulant property of ximelagatran may reduce cardiovascular events, it was found to increase some proinflammatory markers.
Thus, as a member of the same drug class, dabigatran might have effects that are unfavorable to atherosclerosis or atherosclerotic thrombotic events.