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Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin
Commentary on: Larsen TB, Rasmussen LH, Gorst-Rasmussen A, et al. Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: a nationwide cohort study. Am J Med 2014;127:1172–8 . Context Randomised trials have shown that patients with atrial fibrillation (AF) who are treated with a non-vitamin K antagonist oral anticoagulant (NOAC), compared with warfarin, have similar or lower rates of stroke and major bleeding, markedly reduced rates of intracranial bleeding and a consistent pattern of reduced mortality.1 Dabigatran 150 mg two times a day is the only NOAC that can significantly...
Source: Evidence-Based Medicine - May 22, 2015 Category: Internal Medicine Authors: Eikelboom, J. W., Bosch, J. Tags: Epidemiologic studies, Time-to-event methods, Drugs: cardiovascular system, Stroke, Arrhythmias Aetiology/Harm Source Type: research

Standard and reduced doses of dabigatran, rivaroxaban, and apixaban for stroke prevention in atrial fibrillation: a nationwide cohort study
ConclusionsStandard and reduced dose NOACs, respectively, showed no significant risk difference for associated stroke/thromboembolism. Rivaroxaban was associated with higher bleeding risk compared with dabigatran and apixaban, and dabigatran was associated with lower intracranial bleeding risk compared with rivaroxaban and apixaban.This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - September 1, 2017 Category: Internal Medicine Authors: Laila Staerk, Thomas A Gerds, Gregory Y H Lip, Brice Ozenne, Anders N Bonde, Morten Lamberts, Emil L Fosb øl, Christian Torp‐Pedersen, Gunnar H Gislason, Jonas B Olesen Tags: Original Article Source Type: research

Standard and reduced doses of dabigatran, rivaroxaban and apixaban for stroke prevention in atrial fibrillation: a nationwide cohort study
ConclusionsStandard and reduced dose NOACs, respectively, showed no significant risk difference for associated stroke/thromboembolism. Rivaroxaban was associated with higher bleeding risk compared with dabigatran and apixaban and dabigatran was associated with lower intracranial bleeding risk compared with rivaroxaban and apixaban.
Source: Journal of Internal Medicine - September 21, 2017 Category: Internal Medicine Authors: L. Staerk, T. A. Gerds, G. Y. H. Lip, B. Ozenne, A. N. Bonde, M. Lamberts, E. L. Fosb øl, C. Torp‐Pedersen, G. H. Gislason, J. B. Olesen Tags: Original Article Source Type: research

Resumption of anticoagulation after major bleeding decreases the risk of stroke in patients with atrial fibrillation
This study aimed to (1) evaluate anticoagulation use after a major bleeding event on dabigatran or warfarin and (2) compare outcomes between patients discontinuing anticoagulation and those restarting dabigatran or warfarin. Methods This was...
Source: Evidence-Based Medicine - June 9, 2017 Category: Internal Medicine Authors: Smit, M. D., Van Gelder, I. C. Tags: Therapeutics/Prevention Source Type: research

Dabigatran increased bleeding and stroke compared with warfarin after mechanical heart valve implantation.
PMID: 24343411 [PubMed - in process]
Source: Annals of Internal Medicine - December 17, 2013 Category: Internal Medicine Authors: Kolias TJ Tags: Ann Intern Med Source Type: research

Controversies regarding the new oral anticoagulants for stroke prevention in patients with atrial fibrillation
This article raises 10 controversial issues regarding the use of NOACs for stroke prevention in patients with atrial fibrillation, and offers a review of the latest available evidence. We provide a brief overview of the mechanism and dosing of these drugs, as well as a summary of the key clinical trials that have brought them into the spotlight. Comparative considerations relative to warfarin such as NOAC safety, efficacy, bleeding risk, reversibility, drug-transitioning and use in patients well controlled on warfarin are addressed. Use in select populations such as the elderly, those with coronary disease, renal impairmen...
Source: Vascular Medicine recent issues - May 30, 2014 Category: Internal Medicine Authors: Mohanty, B. D., Looser, P. M., Gokanapudy, L. R., Handa, R., Mohanty, S., Choi, S. S., Goldman, M. E., Fuster, V., Halperin, J. L. Tags: Review Articles Source Type: research

Successful dabigatran reversal after subdural hemorrhage using idarucizumab in a mobile stroke unit: A case report
Rationale: Idarucizumab is a specific reversal agent for patients with bleeding related to the anticoagulant dabigatran. There are no prior descriptions of Idarucizumab administration in the prehospital setting for intracranial hemorrhage. Patient concerns: An 82-year-old woman treated with dabigatran for atrial fibrillation developed acute focal weakness. This led to activation of emergency medical services and assessment in the mobile stroke unit (MSU). Diagnosis: Computed tomography of the brain performed in the MSU revealed an acute subdural hematoma. Interventions: The patient was treated with Idarucizumab ...
Source: Medicine - May 1, 2020 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Delaying clinical events among patients with non-valvular atrial fibrillation treated with oral anticoagulants: Insights from the ARISTOPHANES study
CONCLUSIONS: Over 12 months after initiation, apixaban and dabigatran conferred progressive increases in event free time for stroke/SE and MB vs warfarin, whereas rivaroxaban conferred an increase in stroke/SE-free time but a loss in MB-free time vs warfarin.PMID:36456387 | DOI:10.1016/j.ejim.2022.10.021
Source: European Journal of Internal Medicine - December 1, 2022 Category: Internal Medicine Authors: Steven Deitelzweig Allison Keshishian Amiee Kang Aaron Jenkins Nipun Atreja Patricia Schuler Jenny Jiang Huseyin Yuce Xiaoxi Sun Gregory Y H Lip Source Type: research

A Review of Oral Anticoagulants in Patients with Atrial Fibrillation
Arnold J. Greenspon, MD DOI: 10.3810/pgm.2012.11.2608 Abstract: There is a high prevalence of atrial fibrillation in the United States, particularly in the elderly population. Patients with atrial fibrillation are at an increased risk of stroke and anticoagulant therapy is recommended. However, many eligible patients are not receiving therapy due to limitations and concerns related to the use of the vitamin K antagonist warfarin, such as slow onset of action, variable drug metabolism, risk of bleeding, and requirement for monitoring. Novel oral anticoagulants (NOACs) have been developed and may be used as an alternat...
Source: Postgraduate Medicine Online - December 26, 2012 Category: Internal Medicine Authors: admin Source Type: research

Outcomes of Dabigatran and Warfarin for Atrial Fibrillation in Contemporary Practice: A Retrospective Cohort Study.
Conclusion: In matched adults with atrial fibrillation treated in practice, the incidences of stroke and bleeding with dabigatran versus warfarin were consistent with those seen in trials. The possible relationship between dabigatran and myocardial infarction warrants further investigation. Primary Funding Source: U.S. Food and Drug Administration. PMID: 29132153 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - November 14, 2017 Category: Internal Medicine Authors: Go AS, Singer DE, Toh S, Cheetham TC, Reichman ME, Graham DJ, Southworth MR, Zhang R, Izem R, Goulding MR, Houstoun M, Mott K, Sung SH, Gagne JJ Tags: Ann Intern Med Source Type: research

Comparison of dabigatran and warfarin used in patients with non-valvular atrial fibrillation: Meta-analysis of random control trial
Conclusion: No significant difference was obtained between 110 mg dabigatran and warfarin in the incidence of stroke and embolic events. However, the 110 mg dabigatran associated lower incidence of bleeding compare with warfarin. When compared with 150 mg dabigatran, warfarin associated with lower incidence of stroke and embolic events but similar in the incidence of bleeding.
Source: Medicine - November 1, 2018 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Interventions for Preventing Thromboembolic Events in Patients With Atrial Fibrillation: A Systematic Review.
Conclusion: The available direct-acting oral anticoagulants (DOACs) are at least as effective and safe as warfarin for patients with nonvalvular AF. The DOACs had similar benefits across several patient subgroups and seemed safe and efficacious for a wide range of patients with nonvalvular AF. Primary Funding Source: Patient-Centered Outcomes Research Institute. (PROSPERO: CRD42017069999). PMID: 30383133 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - October 30, 2018 Category: Internal Medicine Authors: Lowenstern A, Al-Khatib SM, Sharan L, Chatterjee R, LaPointe NMA, Shah B, Borre ED, Raitz G, Goode A, Yapa R, Davis JK, Lallinger K, Schmidt R, Kosinski AS, Sanders GD Tags: Ann Intern Med Source Type: research

Effectiveness and Safety of Direct Oral Anticoagulants Versus Warfarin in Patients With Valvular Atrial Fibrillation : A Population-Based Cohort Study
CONCLUSION: In this comparative effectiveness study using practice-based claims data, patients with valvular AF who were new users of DOACs had lower risks for ischemic stroke or systemic embolism and major bleeding than new users of warfarin. These data may be used to guide risk-benefit discussions regarding anticoagulant choices for patients with valvular AF.PRIMARY FUNDING SOURCE: None.PMID:33780291 | DOI:10.7326/M20-6194
Source: Annals of Internal Medicine - March 29, 2021 Category: Internal Medicine Authors: Ghadeer K Dawwas Eric Dietrich Adam Cuker Geoffrey D Barnes Charles E Leonard James D Lewis Source Type: research

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