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September 10, 2015Thrombosis and Haemostasis

Dabigatran use in elderly patients with atrial fibrillation

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Why the study?

Does dabigatran reduce stroke and bleeding events compared to warfarin in elderly patients with atrial fibrillation?

Population

63,110 patients with atrial fibrillation, 67.3% elderly, based in Quebec.

Comparison

Dabigatran (110 mg or 150 mg) vs Matched warfarin users

Design

Cohort

Authors

MAMeytal Avgil-TsadokClalit Health ServicesCJCynthia A. JackeviciusPreventive CardiologyVEVidal EssebagElectrophysiology

Discussion

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Implication

Dabigatran in elderly patients warrants vigilance amid efficacy gaps; observational data leaves comparative effectiveness open.

Structured PICO

Does dabigatran reduce stroke and bleeding events compared to warfarin in elderly patients with atrial fibrillation?

P
Population
63,110 patients with atrial fibrillation (15,918 dabigatran users and 47,192 matched warfarin users), 67.3% elderly (≥ 75 years), based in Quebec (1999-2013).
I
Intervention
Dabigatran (110 mg or 150 mg)
C
Comparator
Matched warfarin users
O
Outcome
Stroke and bleeding events (intracranial haemorrhage, gastrointestinal bleeding)hard clinical

In real-world elderly patients with atrial fibrillation, dabigatran offers similar stroke prevention to warfarin with less intracranial bleeding but increased gastrointestinal bleeding.

Cite This Study

Avgil-Tsadok et al. (2015) studied this question.

synapsesocial.com/papers/6a7005c6f44fa9f079dd8afchttps://doi.org/10.1160/th15-03-0247

Topics

Atrial fibrillationAnticoagulation in AFPersistent AF management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Dabigatran versus Warfarin in Patients with Atrial Fibrillation2009 · 11,282 citations
  2. 2Cardiovascular, Bleeding, and Mortality Risks in Elderly Medicare Patients Treated With Dabigatran or Warfarin for Nonvalvular Atrial Fibrillation2014 · 648 citations
  3. 3The Use of Dabigatran in Elderly Patients2011 · 204 citations
  4. 4Dabigatran-Induced Gastrointestinal Bleeding in an Elderly Patient with Moderate Renal Impairment2012 · 103 citations
  5. 5Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation2011 · 1,082 citations