Patient Characteristics and Clinical Outcomes with Low-Dose Dabigatran
Background/aimsDabigatran, an oral direct thrombin inhibitor, is used in patients with non-valvular atrial fibrillation to reduce thromboembolic events. Whereas the 150 mg dosing regimen has been extensively studied in clinical setting, to date, there is no clinical data on the 75 mg (low dose, “LD”...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/article/10.3389/fcvm.2017.00042/full |
| _version_ | 1818550416483287040 |
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| author | Ramin Ebrahimi Ramin Ebrahimi Janet K. Han Janet K. Han Seung H. Goe Michelle Treadwell Zenaida Feliciano Zenaida Feliciano |
| author_facet | Ramin Ebrahimi Ramin Ebrahimi Janet K. Han Janet K. Han Seung H. Goe Michelle Treadwell Zenaida Feliciano Zenaida Feliciano |
| author_sort | Ramin Ebrahimi |
| collection | DOAJ |
| description | Background/aimsDabigatran, an oral direct thrombin inhibitor, is used in patients with non-valvular atrial fibrillation to reduce thromboembolic events. Whereas the 150 mg dosing regimen has been extensively studied in clinical setting, to date, there is no clinical data on the 75 mg (low dose, “LD”) regimen. In this study, we evaluated patient characteristics and clinical outcomes in 49 patients treated with LD dabigatran.MethodsElectronic medical records were utilized to compare patients from one medical center treated with LD dabigatran to those from the warfarin arm of the RE-LY trial.ResultsCompared to those from the warfarin arm of the RE-LY trial, the LD dabigatran patients were significantly older (82.6 vs. 71.6 years, p < 0.001), had higher prevalence of diabetes (42.9 vs. 23%, p < 0.001), were predominantly male (100 vs. 63.3%, p < 0.001), and had higher CHADS2 score (2.8 vs. 2.1, p < 0.001). Only 9 (18%) patients had creatinine clearance of <30 ml/min and none were on concomitant medications that required dose adjustment to LD dabigatran. During a mean follow up of 10.1 months, there were no thromboembolic events, no cerebrovascular events, and seven bleeding events in the LD dabigatran group of which only two required blood transfusion.ConclusionIn this database, most patients received LD dabigatran based on characteristics not related to the approved indications for this dose. The exploratory clinical outcomes of using LD dabigatran outside of the current approved indications are promising in this high-risk population and deserve further investigation to better understand the role of LD dabigatran in clinical practice. |
| first_indexed | 2024-12-12T08:46:11Z |
| format | Article |
| id | doaj.art-9810bff9813e4f42aaea5c2c49668708 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-12T08:46:11Z |
| publishDate | 2017-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-9810bff9813e4f42aaea5c2c496687082022-12-22T00:30:32ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2017-07-01410.3389/fcvm.2017.00042251210Patient Characteristics and Clinical Outcomes with Low-Dose DabigatranRamin Ebrahimi0Ramin Ebrahimi1Janet K. Han2Janet K. Han3Seung H. Goe4Michelle Treadwell5Zenaida Feliciano6Zenaida Feliciano7Department of Cardiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United StatesDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, United StatesDepartment of Cardiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United StatesDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, United StatesDepartment of Pharmacy, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United StatesDepartment of Cardiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United StatesDepartment of Cardiology, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United StatesDepartment of Medicine, University of California, Los Angeles, Los Angeles, CA, United StatesBackground/aimsDabigatran, an oral direct thrombin inhibitor, is used in patients with non-valvular atrial fibrillation to reduce thromboembolic events. Whereas the 150 mg dosing regimen has been extensively studied in clinical setting, to date, there is no clinical data on the 75 mg (low dose, “LD”) regimen. In this study, we evaluated patient characteristics and clinical outcomes in 49 patients treated with LD dabigatran.MethodsElectronic medical records were utilized to compare patients from one medical center treated with LD dabigatran to those from the warfarin arm of the RE-LY trial.ResultsCompared to those from the warfarin arm of the RE-LY trial, the LD dabigatran patients were significantly older (82.6 vs. 71.6 years, p < 0.001), had higher prevalence of diabetes (42.9 vs. 23%, p < 0.001), were predominantly male (100 vs. 63.3%, p < 0.001), and had higher CHADS2 score (2.8 vs. 2.1, p < 0.001). Only 9 (18%) patients had creatinine clearance of <30 ml/min and none were on concomitant medications that required dose adjustment to LD dabigatran. During a mean follow up of 10.1 months, there were no thromboembolic events, no cerebrovascular events, and seven bleeding events in the LD dabigatran group of which only two required blood transfusion.ConclusionIn this database, most patients received LD dabigatran based on characteristics not related to the approved indications for this dose. The exploratory clinical outcomes of using LD dabigatran outside of the current approved indications are promising in this high-risk population and deserve further investigation to better understand the role of LD dabigatran in clinical practice.http://journal.frontiersin.org/article/10.3389/fcvm.2017.00042/fulllow-dose dabigatranatrial fibrillationdabigatran 75 mgoral anticoagulantpatient demographics |
| spellingShingle | Ramin Ebrahimi Ramin Ebrahimi Janet K. Han Janet K. Han Seung H. Goe Michelle Treadwell Zenaida Feliciano Zenaida Feliciano Patient Characteristics and Clinical Outcomes with Low-Dose Dabigatran Frontiers in Cardiovascular Medicine low-dose dabigatran atrial fibrillation dabigatran 75 mg oral anticoagulant patient demographics |
| title | Patient Characteristics and Clinical Outcomes with Low-Dose Dabigatran |
| title_full | Patient Characteristics and Clinical Outcomes with Low-Dose Dabigatran |
| title_fullStr | Patient Characteristics and Clinical Outcomes with Low-Dose Dabigatran |
| title_full_unstemmed | Patient Characteristics and Clinical Outcomes with Low-Dose Dabigatran |
| title_short | Patient Characteristics and Clinical Outcomes with Low-Dose Dabigatran |
| title_sort | patient characteristics and clinical outcomes with low dose dabigatran |
| topic | low-dose dabigatran atrial fibrillation dabigatran 75 mg oral anticoagulant patient demographics |
| url | http://journal.frontiersin.org/article/10.3389/fcvm.2017.00042/full |
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