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Risk factors and prevention of dabigatran‐related gastrointestinal bleeding in patients with atrial fibrillation
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 wha...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828263/ https://www.ncbi.nlm.nih.gov/pubmed/29721111 http://dx.doi.org/10.1002/joa3.12015 |
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author | Nantsupawat, Teerapat Soontrapa, Suthipong Nantsupawat, Nopakoon Sotello, David Klomjit, Saranapoom Adabag, Selcuk Perez‐Verdia, Alejandro |
author_facet | Nantsupawat, Teerapat Soontrapa, Suthipong Nantsupawat, Nopakoon Sotello, David Klomjit, Saranapoom Adabag, Selcuk Perez‐Verdia, Alejandro |
author_sort | Nantsupawat, Teerapat |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5828263 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-58282632018-05-02 Risk factors and prevention of dabigatran‐related gastrointestinal bleeding in patients with atrial fibrillation Nantsupawat, Teerapat Soontrapa, Suthipong Nantsupawat, Nopakoon Sotello, David Klomjit, Saranapoom Adabag, Selcuk Perez‐Verdia, Alejandro J Arrhythm Original Articles 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. John Wiley and Sons Inc. 2017-12-14 /pmc/articles/PMC5828263/ /pubmed/29721111 http://dx.doi.org/10.1002/joa3.12015 Text en © 2017 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of the Japanese Heart Rhythm Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Nantsupawat, Teerapat Soontrapa, Suthipong Nantsupawat, Nopakoon Sotello, David Klomjit, Saranapoom Adabag, Selcuk Perez‐Verdia, Alejandro Risk factors and prevention of dabigatran‐related gastrointestinal bleeding in patients with atrial fibrillation |
title | Risk factors and prevention of dabigatran‐related gastrointestinal bleeding in patients with atrial fibrillation |
title_full | Risk factors and prevention of dabigatran‐related gastrointestinal bleeding in patients with atrial fibrillation |
title_fullStr | Risk factors and prevention of dabigatran‐related gastrointestinal bleeding in patients with atrial fibrillation |
title_full_unstemmed | Risk factors and prevention of dabigatran‐related gastrointestinal bleeding in patients with atrial fibrillation |
title_short | Risk factors and prevention of dabigatran‐related gastrointestinal bleeding in patients with atrial fibrillation |
title_sort | risk factors and prevention of dabigatran‐related gastrointestinal bleeding in patients with atrial fibrillation |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5828263/ https://www.ncbi.nlm.nih.gov/pubmed/29721111 http://dx.doi.org/10.1002/joa3.12015 |
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