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Erez A, Golovchiner G, Klempfner R, et al. Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study. Cardiology. 2021;146(5):641-645doi: 10.1159/000516368.
Erez, A., Golovchiner, G., Klempfner, R., Kadmon, E., Goldenberg, G. R., Goldenberg, I., & Barsheshet, A. (2021). Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study. Cardiology, 146(5), 641-645. https://doi.org/10.1159/000516368
Erez, Aharon, et al. "Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study." Cardiology vol. 146,5 (2021): 641-645. doi: https://doi.org/10.1159/000516368
Erez A, Golovchiner G, Klempfner R, Kadmon E, Goldenberg GR, Goldenberg I, Barsheshet A. Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study. Cardiology. 2021;146(5):641-645. doi: 10.1159/000516368. Epub 2021 Jun 11. PMID: 34120112.
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Cardiology. 2021;146(5):641-645. doi: 10.1159/000516368. Epub 2021 Jun 11.

Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study.

Cardiology

Aharon Erez, Gregory Golovchiner, Robert Klempfner, Ehud Kadmon, Gustavo Ruben Goldenberg, Ilan Goldenberg, Alon Barsheshet

Affiliations

  1. Cardiology Department, Rabin Medical Center, Petah-Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
  2. Heart Institute, Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
  3. Clinical Cardiovascular Research Center, University of Rochester Medical Center, Rochester, New York, USA.

PMID: 34120112 DOI: 10.1159/000516368

Abstract

INTRODUCTION: In patients with atrial fibrillation (AF) at risk for stroke, dabigatran 150 mg twice a day (DE150) is superior to warfarin for stroke prevention. However, there is paucity of data with respect to bleeding risk at this dose in elderly patients (≥75 years). We aimed to evaluate the safety of DE150 in comparison to warfarin in a real-world population with AF and low bleeding risk (HAS-BLED score ≤2).

METHODS: In this prospective observational study, 754 consecutive patients with AF and HAS-BLED score ≤2 were included. We compared outcome of elderly patients (age ≥75 tears) to younger patients (age <75 years). The primary end point was the combined incidence of all-cause mortality, stroke, systemic emboli, and major bleeding event during a mean follow-up of 1 year.

RESULTS: There were 230 (30%) elderly patients, 151 patients were treated with warfarin, and 79 were treated with DE150. Fifty-two patients experienced the primary endpoint during the 1-year follow-up. Among the elderly, at 1-year of follow-up, the cumulative event rate of the combined endpoint in the DE150 and warfarin was 8.9 and 15.9% respectively (p = 0.14). After adjustment for age and gender, patients who were treated with DE150 had a nonsignificant difference in the risk for the combined end point as patients treated with warfarin both among the elderly and among the younger population (HR 0.58, 95% C.I = 0.25-1.39 and HR = 1.12, 95% C.I 0.62-2.00, respectively [p for age-group-by-treatment interaction = 0.83).

CONCLUSIONS: Our results suggest that Dabigatran 150 mg twice a day can be safely used among elderly AF patients with low bleeding risk.

© 2021 S. Karger AG, Basel.

Keywords: Atrial fibrillation; Dabigatran; Elderly

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