Open AccessRisk factors and prevention of dabigatran‐related gastrointestinal bleeding in patients with atrial fibrillation
Author(s) -
Nantsupawat Teerapat,
Soontrapa Suthipong,
Nantsupawat Nopakoon,
Sotello David,
Klomjit Saranapoom,
Adabag Selcuk,
PerezVerdia Alejandro
Publication year - 2018
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1002/joa3.12015
Subject(s) - medicine , dabigatran , atrial fibrillation , warfarin , gastrointestinal bleeding , odds ratio , stroke (engine) , cohort , retrospective cohort study , mechanical engineering , engineering
Abstract 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 /H2 RA users vs 4 (2.6%) in non‐ PPI /H2 RA 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 /H2 RA 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.