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Periprocedural Blee...
Periprocedural Bleeding and Thromboembolic Events With Dabigatran Compared With Warfarin Results From the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) Randomized Trial
- Article/chapterEnglish2012
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LIBRIS-ID:oai:DiVA.org:uu-180283
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-180283URI
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https://doi.org/10.1161/CIRCULATIONAHA.111.090464DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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Background-Dabigatran reduces ischemic stroke in comparison with warfarin; however, given the lack of antidote, there is concern that it might increase bleeding when surgery or invasive procedures are required.Methods and Results-The current analysis was undertaken to compare the periprocedural bleeding risk of patients in the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial treated with dabigatran and warfarin. Bleeding rates were evaluated from 7 days before until 30 days after invasive procedures, considering only the first procedure for each patient. A total of 4591 patients underwent at least 1 invasive procedure: 24.7% of patients received dabigatran 110 mg, 25.4% received dabigatran 150 mg, and 25.9% received warfarin, P=0.34. Procedures included: pacemaker/defibrillator insertion (10.3%), dental procedures (10.0%), diagnostic procedures (10.0%), cataract removal (9.3%), colonoscopy (8.6%), and joint replacement (6.2%). Among patients assigned to either dabigatran dose, the last dose of study drug was given 49 (35-85) hours before the procedure on comparison with 114 (87-144) hours in patients receiving warfarin, P<0.001. There was no significant difference in the rates of periprocedural major bleeding between patients receiving dabigatran 110 mg (3.8%) or dabigatran 150 mg (5.1%) or warfarin (4.6%); dabigatran 110 mg versus warfarin: relative risk, 0.83; 95% CI, 0.59 to 1.17; P=0.28; dabigatran 150 mg versus warfarin: relative risk, 1.09; 95% CI, 0.80 to 1.49; P=0.58. Among patients having urgent surgery, major bleeding occurred in 17.8% with dabigatran 110 mg, 17.7% with dabigatran 150 mg, and 21.6% with warfarin: dabigatran 110 mg; relative risk, 0.82; 95% CI, 0.48 to 1.41; P=0.47; dabigatran 150 mg: relative risk, 0.82; 95% CI, 0.50 to 1.35; P=0.44.Conclusions-Dabigatran and warfarin were associated with similar rates of periprocedural bleeding, including patients having urgent surgery. Dabigatran facilitated a shorter interruption of oral anticoagulation.
Subject headings and genre
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anticoagulants
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atrial fibrillation
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stroke prevention
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surgery
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perioperative
Added entries (persons, corporate bodies, meetings, titles ...)
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Eikelboom, John
(author)
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Douketis, James
(author)
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Wallentin, Lars,1943-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),kardiologi(Swepub:uu)larswall
(author)
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Oldgren, JonasUppsala universitet,Uppsala kliniska forskningscentrum (UCR),kardiologi(Swepub:uu)jonaoldg
(author)
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Yang, Sean
(author)
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Themeles, Ellison
(author)
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Heidbuchle, Hein
(author)
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Avezum, Alvaro
(author)
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Reilly, Paul
(author)
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Connolly, Stuart J.
(author)
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Yusuf, Salim
(author)
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Ezekowitz, Michael
(author)
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Uppsala universitetUppsala kliniska forskningscentrum (UCR)
(creator_code:org_t)
Related titles
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In:Circulation126:3, s. 343-3480009-73221524-4539
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Healey, Jeff S.
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Eikelboom, John
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Douketis, James
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Wallentin, Lars, ...
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Oldgren, Jonas
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Yang, Sean
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Themeles, Elliso ...
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Heidbuchle, Hein
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Avezum, Alvaro
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Reilly, Paul
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Connolly, Stuart ...
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Yusuf, Salim
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Ezekowitz, Micha ...
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Circulation
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Uppsala University