Dabigatran in secondary stroke prevention: clinical experience with 106 patients.

Abstract

INTRODUCTION:

Our aim was to analyze our clinical experience with dabigatran etexilate in secondary stroke prevention.

METHODS:

We retrospectively included patients starting dabigatran etexilate for secondary stroke prevention from March 2010 to December 2012. Efficacy and safety variables were registered.

RESULTS:

106 patients were included, median follow-up of 12 months (range 1-31). Fifty-six females (52.8%), mean age 76.4 (range 50-95, SD 9.8), median CHADS2 4 (range 2-6), CHA2DS2-VASc 5 (range 2-9), and HAS-BLED 2 (range 1-5). Indication for dabigatran etexilate was ischemic stroke in 101 patients and acute cerebral hemorrhage (CH) due to warfarin in 5 (4.7%). Dabigatran etexilate 110 mg bid was prescribed in 71 cases (67%) and 150 mg bid was prescribed in the remaining. Seventeen patients (16%) suffered 20 complications during follow-up. Ischemic complications (10) were 6 transient ischemic attacks (TIA), 3 ischemic strokes, and 1 acute coronary syndrome. Hemorrhagic complications (10) were CH (1), gastrointestinal bleeding (6), mild hematuria (2), and mild metrorrhagia (1), leading to dabigatran etexilate discontinuation in 3 patients. Patients with previous CH remained uneventful. Three patients died (pneumonia, congestive heart failure, and acute cholecystitis) and 9 were lost during follow-up.

CONCLUSIONS:

Dabigatran etexilate was safe and effective in secondary stroke prevention in clinical practice, including a small number of patients with previous history of CH.

• Authors: Alicia DeFelipe-Mimbrera, Araceli Alonso Cánovas, Marta Guillán, Consuelo Matute, Susana Sainz de la Maza, Antonio Cruz, Rocío Vera, Jaime Masjuan
• Journal: BioMed research international (Biomed Res Int) Vol. 2014 Pg. 567026 ( 2014) ISSN: 2314-6141 [Electronic] United States
• PMID: 25133166 (Publication Type: Journal Article)

Chemical References

• Benzimidazoles
• beta-Alanine
• Dabigatran

Topics

• Aged
• Aged, 80 and over
• Benzimidazoles (adverse effects, therapeutic use)
• Brain Ischemia (chemically induced)
• Dabigatran
• Female
• Hemorrhage (chemically induced)
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Stroke (drug therapy, prevention & control)
• beta-Alanine (adverse effects, analogs & derivatives, therapeutic use)