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Statins and the risk of bleeding in patients taking dabigatran

Bo-Lin Ho1,2, Ya-Ju Lin3, Sheng-Feng Lin4

  • 1Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Acta Neurologica Scandinavica
|February 12, 2019
PubMed

Insights

For patients with non-valvular atrial fibrillation (NVAF) on dabigatran etexilate, concurrent statin use was linked to a significantly lower risk of bleeding complications. This suggests statins may enhance safety when used with this anticoagulant.

Area of Science:

  • Cardiology
  • Pharmacology
  • Neurology

Background:

  • Dabigatran etexilate is a direct thrombin inhibitor for stroke prevention in non-valvular atrial fibrillation (NVAF).
  • Statins are widely used for cardiovascular disease prevention.
  • The safety of co-administering statins with dabigatran etexilate is not well understood.

Purpose of the Study:

  • To evaluate the safety and persistence of dabigatran etexilate when co-prescribed with statins.
  • To assess the bleeding risk in NVAF patients on dabigatran and statins.

Main Methods:

  • Prospective, multicenter registry study.
  • Inclusion of NVAF patients initiating dabigatran therapy after ischemic stroke (2013-2017).
  • Primary outcome: symptomatic bleeding at 90, 180, and 360 days.

Main Results:

  • 652 patients (336 statin users, 316 non-users) were followed for 1 year.
  • Statin users exhibited a significantly lower bleeding risk (adjusted hazard ratio: 0.11, P < 0.001).
  • Higher bleeding-free survival rates were observed in patients prescribed statins (P = 0.028).

Conclusions:

  • Co-prescription of statins with dabigatran etexilate is associated with reduced bleeding risk in NVAF patients undergoing secondary stroke prevention.
  • Further research is warranted to elucidate the underlying pharmacological mechanisms.
  • This finding suggests a potentially safer therapeutic strategy for NVAF patients requiring anticoagulation and statin therapy.
Abstract

Keywords:
anticoagulantatrial fibrillationbleedingco-medicationdabigatranstatin

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