TY - JOUR
T1 - Risk factors and prevention of dabigatran-related gastrointestinal bleeding in patients with atrial fibrillation
AU - Nantsupawat, Teerapat
AU - Soontrapa, Suthipong
AU - Nantsupawat, Nopakoon
AU - Sotello, David
AU - Klomjit, Saranapoom
AU - Adabag, Selcuk
AU - Perez-Verdia, Alejandro
N1 - Publisher Copyright:
© 2017 The Authors.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Introduction: Dabigatran, as compared with warfarin, was associated with lower rates of stroke and systemic embolism with similar rates of major hemorrhage. But it has a significantly higher risk of gastrointestinal bleeding (GIB). There are limited data on how to prevent GIB from dabigatran and what are the risk factors. Methods: We performed a retrospective cohort study of patients with atrial fibrillation who have ever taken dabigatran for thromboprophylaxis from October 2010 to February 2013. Results: A total of 247 patients were identified. There were 10 (4%) patients who developed GIB (6 (6.5%) in PPI/H2RA users vs 4 (2.6%) in non-PPI/H2RA users; P =.184). History of GIB within 1 year prior to dabigatran initiation and HAS-BLED score ≥3 are independent risk factors for GIB, with odds ratio of 25.14 (95% CI, 2.85-221.47; P <.01) and 5.85 (95% CI, 1.31-26.15; P =.021), respectively. Conclusion: In this real-world cohort, PPI/H2RA use was not associated with reduced GIB events. HAS-BLED score ≥3 and prior history of GIB within 1 year are independent risk factors for GIB among dabigatran users.
AB - Introduction: Dabigatran, as compared with warfarin, was associated with lower rates of stroke and systemic embolism with similar rates of major hemorrhage. But it has a significantly higher risk of gastrointestinal bleeding (GIB). There are limited data on how to prevent GIB from dabigatran and what are the risk factors. Methods: We performed a retrospective cohort study of patients with atrial fibrillation who have ever taken dabigatran for thromboprophylaxis from October 2010 to February 2013. Results: A total of 247 patients were identified. There were 10 (4%) patients who developed GIB (6 (6.5%) in PPI/H2RA users vs 4 (2.6%) in non-PPI/H2RA users; P =.184). History of GIB within 1 year prior to dabigatran initiation and HAS-BLED score ≥3 are independent risk factors for GIB, with odds ratio of 25.14 (95% CI, 2.85-221.47; P <.01) and 5.85 (95% CI, 1.31-26.15; P =.021), respectively. Conclusion: In this real-world cohort, PPI/H2RA use was not associated with reduced GIB events. HAS-BLED score ≥3 and prior history of GIB within 1 year are independent risk factors for GIB among dabigatran users.
KW - Atrial fibrillation
KW - Dabigatran
KW - Gastrointestinal bleeding
KW - HAS-BLED
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U2 - 10.1002/joa3.12015
DO - 10.1002/joa3.12015
M3 - Article
C2 - 29721111
AN - SCOPUS:85051240400
SN - 1880-4276
VL - 34
SP - 30
EP - 35
JO - Journal of Arrhythmia
JF - Journal of Arrhythmia
IS - 1
ER -
