Dabigatran Compared with Warfarin for Stroke Prevention in Patients with Atrial Fibrillation: An Evidence Based Case Report
Background. Atrial fibrillation (AF) increases the risk of having stroke as high as five fold. Anticoagulant administration such as vitamin K antagonist has been used regularly to reduce the occurence of stroke. Despite the high efficacy, warfarin has several limitations, including a narrow therapeu...
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| Format: | Article |
| Language: | English |
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Indonesian Heart Association
2013-06-01
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| Series: | Majalah Kardiologi Indonesia |
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| Online Access: | http://ijconline.id/index.php/ijc/article/view/86 |
| _version_ | 1828515869084352512 |
|---|---|
| author | Alvin Nursalim Yoga Yuniadi |
| author_facet | Alvin Nursalim Yoga Yuniadi |
| author_sort | Alvin Nursalim |
| collection | DOAJ |
| description | Background. Atrial fibrillation (AF) increases the risk of having stroke as high as five fold. Anticoagulant administration such as vitamin K antagonist has been used regularly to reduce the occurence of stroke. Despite the high efficacy, warfarin has several limitations, including a narrow therapeutic window, multiple food and drug interactions, and the need for frequent laboratory monitoring. Dabigatran, an oral thrombin inhibitor, displays some positive characteristics as the solution to warfarins limitations.
Aim. To determine the efficacy of dabigatran compared to warfarin for stroke prevention in patients with atrial fibrillation.
Methods. A search was conducted on PubMed and Google. The selection of title and abstract was done using inclusion and exclusion criteria. Five original articles were found, but only one study was used. The selected study was critically appraised for its validity, importance and applicability.
Result. The administration of 150 mg of dabigatran was superior to warfarin with respect of stroke. The relative risk reduction was 36% in the 150 mg dabigatran group. The rate of stroke was 1.01% per year in the group that received 150 mg dabigatran, as compared with 1.57% per year in the warfarin group (relative risk 0.64; 95% confidence interval, 0.51 to 0.81, p<0.001). The administration of dabigatran increased the risk of gastrointestinal bleeding.
Conclusion. In patients with atrial fibrillation, dabigatran given at a dose of 150 mg, as compared with warfarin, was associated with lower rate of stroke. Dabigatran administration requires closed gastrointestinal monitoring. |
| first_indexed | 2024-12-11T18:18:57Z |
| format | Article |
| id | doaj.art-8a66932f3df64f36a18245e060258d4c |
| institution | Directory Open Access Journal |
| issn | 0126-3773 2620-4762 |
| language | English |
| last_indexed | 2024-12-11T18:18:57Z |
| publishDate | 2013-06-01 |
| publisher | Indonesian Heart Association |
| record_format | Article |
| series | Majalah Kardiologi Indonesia |
| spelling | doaj.art-8a66932f3df64f36a18245e060258d4c2022-12-22T00:55:19ZengIndonesian Heart AssociationMajalah Kardiologi Indonesia0126-37732620-47622013-06-0132410.30701/ijc.v32i4.86Dabigatran Compared with Warfarin for Stroke Prevention in Patients with Atrial Fibrillation: An Evidence Based Case ReportAlvin Nursalim0Yoga Yuniadi1Faculty of Medicine University of IndonesiaDepartment of Cardiology and Vascular Medicine, Faculty of Medicine, University of IndonesiaBackground. Atrial fibrillation (AF) increases the risk of having stroke as high as five fold. Anticoagulant administration such as vitamin K antagonist has been used regularly to reduce the occurence of stroke. Despite the high efficacy, warfarin has several limitations, including a narrow therapeutic window, multiple food and drug interactions, and the need for frequent laboratory monitoring. Dabigatran, an oral thrombin inhibitor, displays some positive characteristics as the solution to warfarins limitations. Aim. To determine the efficacy of dabigatran compared to warfarin for stroke prevention in patients with atrial fibrillation. Methods. A search was conducted on PubMed and Google. The selection of title and abstract was done using inclusion and exclusion criteria. Five original articles were found, but only one study was used. The selected study was critically appraised for its validity, importance and applicability. Result. The administration of 150 mg of dabigatran was superior to warfarin with respect of stroke. The relative risk reduction was 36% in the 150 mg dabigatran group. The rate of stroke was 1.01% per year in the group that received 150 mg dabigatran, as compared with 1.57% per year in the warfarin group (relative risk 0.64; 95% confidence interval, 0.51 to 0.81, p<0.001). The administration of dabigatran increased the risk of gastrointestinal bleeding. Conclusion. In patients with atrial fibrillation, dabigatran given at a dose of 150 mg, as compared with warfarin, was associated with lower rate of stroke. Dabigatran administration requires closed gastrointestinal monitoring.http://ijconline.id/index.php/ijc/article/view/86Dabigatranwarfarinstrokeatrial fibrillation |
| spellingShingle | Alvin Nursalim Yoga Yuniadi Dabigatran Compared with Warfarin for Stroke Prevention in Patients with Atrial Fibrillation: An Evidence Based Case Report Majalah Kardiologi Indonesia Dabigatran warfarin stroke atrial fibrillation |
| title | Dabigatran Compared with Warfarin for Stroke Prevention in Patients with Atrial Fibrillation: An Evidence Based Case Report |
| title_full | Dabigatran Compared with Warfarin for Stroke Prevention in Patients with Atrial Fibrillation: An Evidence Based Case Report |
| title_fullStr | Dabigatran Compared with Warfarin for Stroke Prevention in Patients with Atrial Fibrillation: An Evidence Based Case Report |
| title_full_unstemmed | Dabigatran Compared with Warfarin for Stroke Prevention in Patients with Atrial Fibrillation: An Evidence Based Case Report |
| title_short | Dabigatran Compared with Warfarin for Stroke Prevention in Patients with Atrial Fibrillation: An Evidence Based Case Report |
| title_sort | dabigatran compared with warfarin for stroke prevention in patients with atrial fibrillation an evidence based case report |
| topic | Dabigatran warfarin stroke atrial fibrillation |
| url | http://ijconline.id/index.php/ijc/article/view/86 |
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