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Dabigatran Versus Warfarin in Atrial Fibrillation: Multicenter Experience in Turkey

Onur Aslan1, Y T Yaylali2, S Yildirim3

  • 1Division of Cardiology, Ağrı State Hospital, Ağrı, Turkey.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|August 14, 2014
PubMed

Insights

Dabigatran showed fewer ischemic strokes and deaths compared to warfarin in atrial fibrillation patients. This suggests dabigatran may be a safer alternative for stroke prevention, especially when warfarin monitoring is difficult.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Safety concerns exist regarding dabigatran use.
  • Atrial fibrillation patients with stroke risk require effective anticoagulation.

Purpose of the Study:

  • To compare the safety outcomes of dabigatran versus warfarin in atrial fibrillation patients.
  • To evaluate the incidence of ischemic stroke, intracranial hemorrhage, and all-cause mortality.

Main Methods:

  • Retrospective analysis of 439 patients with atrial fibrillation and stroke risk.
  • Patients were prescribed either dabigatran (n=220) or warfarin (n=219).
  • Outcomes assessed included ischemic stroke, intracranial hemorrhage, and all-cause mortality.

Main Results:

  • Dabigatran was associated with significantly lower rates of ischemic stroke (1.7% vs 6.8% for warfarin, P=.015).
  • Dabigatran showed a trend towards lower intracranial hemorrhage rates (2.4% vs 2.7% for warfarin, P=.104).
  • All-cause mortality was significantly lower in the dabigatran group (1.0% vs 4.6% for warfarin, P=.005).

Conclusions:

  • Dabigatran demonstrated superior safety compared to warfarin regarding ischemic stroke and all-cause mortality.
  • Dabigatran may offer a more favorable risk-benefit profile for stroke prophylaxis in atrial fibrillation.
  • Consider dabigatran when optimal warfarin monitoring is challenging.

Keywords:
drug monitoringhemorrhagemyocardial infarctionstrokethromboembolism

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