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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
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Healey, Jeff S. (author)
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Eikelboom, John (author)
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Douketis, James (author)
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- Wallentin, Lars, 1943- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),kardiologi
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- Oldgren, Jonas (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),kardiologi
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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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(creator_code:org_t)
- 2012
- 2012
- English.
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In: Circulation. - 0009-7322 .- 1524-4539. ; 126:3, s. 343-348
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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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.
Keyword
- anticoagulants
- atrial fibrillation
- stroke prevention
- surgery
- perioperative
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Healey, Jeff S.
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Eikelboom, John
-
Douketis, James
-
Wallentin, Lars, ...
-
Oldgren, Jonas
-
Yang, Sean
-
show more...
-
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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show less...
- Articles in the publication
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Circulation
- By the university
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Uppsala University