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- Publisher Website: 10.1016/j.hrthm.2015.09.015
- Scopus: eid_2-s2.0-84955735163
- PMID: 26392326
- WOS: WOS:000368351500009
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Article: Stroke prevention using dabigatran in elderly Chinese patients with atrial fibrillation
Title | Stroke prevention using dabigatran in elderly Chinese patients with atrial fibrillation |
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Authors | |
Keywords | Atrial fibrillation Chinese Dabigatran Elderly |
Issue Date | 2016 |
Publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal |
Citation | Heart Rhythm, 2016, v. 13 n. 2, p. 366-373 How to Cite? |
Abstract | BACKGROUND: Little is known about the clinical benefit of a non-vitamin K antagonist oral anticoagulant compared with warfarin in elderly Chinese patients with atrial fibrillation (AF). OBJECTIVE: The purpose of this study was to evaluate the clinical benefit of dabigatran in elderly (age >/=80 years) Chinese patients with nonvalvular AF with regard to the risk of ischemic stroke and intracranial hemorrhage (ICH). METHODS: This was an observational study. RESULTS: We studied 571 Chinese patients (mean age 84.8 +/- 4.0 years; 58.1% women) with nonvalvular AF. The primary outcome was hospital admission for ischemic stroke, and the secondary outcome was admission for ICH. The mean CHA2DS2-VASc (congestive heart failure [1 point], hypertension [1 point], age 65-74 years [1 point] and age >/=75 years [2 points], diabetes mellitus [1 point], prior stroke or transient ischemic attack [2 points], vascular disease [1 point], sex category [female] [1 point]) and HAS-BLED (hypertension [1 point], abnormal renal/liver function [1 point], stroke [1 point], bleeding history [1 point] or predisposition [1 point], labile international normalized ratio [1 point], elderly [age >65 years] [1 point], drugs/alcohol concomitantly [1 point]) scores were 4.8 +/- 1.6 and 2.4 +/- 0.8, respectively. Of 571 patients, 129 (22.6%) were taking dabigatran 110 mg twice daily and the remaining were on warfarin. After a mean follow-up of 2.6 years (a total of 1471 patient-years), ischemic stroke occurred in 83 patients on warfarin (6.9% per year) compared with 4 patients on dabigatran (1.4% per year) (hazard ratio 0.22; 95% confidence interval 0.23-0.67). There were 8 incidences of ICH: 7 in patients on warfarin (0.59% per year) and 1 patient on dabigatran (0.35% per year). Dabigatran was associated with a substantially lower ischemic stroke risk (1.4% per year vs 5.4% per year) and similar ICH risk (0.35% per year vs 0.36% per year) as compared with warfarin with time in therapeutic range (TTR) >/=55%. CONCLUSION: In elderly Chinese patients with AF, this study suggested that dabigatran achieved superior stroke risk reduction and similar risk of ICH compared with warfarin with TTR >/=55%. Dabigatran may be preferable to warfarin in elderly patients with AF for stroke prevention, particularly in those with poor TTR. |
Persistent Identifier | http://hdl.handle.net/10722/227375 |
ISSN | 2023 Impact Factor: 5.6 2023 SCImago Journal Rankings: 2.072 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Chan, PHM | - |
dc.contributor.author | Huang, D | - |
dc.contributor.author | Hai, SHJJ | - |
dc.contributor.author | Li, W | - |
dc.contributor.author | Yin, LX | - |
dc.contributor.author | Chan, EW | - |
dc.contributor.author | Wong, ICK | - |
dc.contributor.author | Lau, CP | - |
dc.contributor.author | Chiang, CE | - |
dc.contributor.author | Zhu, J | - |
dc.contributor.author | Tse, HF | - |
dc.contributor.author | Siu, DCW | - |
dc.date.accessioned | 2016-07-18T09:10:06Z | - |
dc.date.available | 2016-07-18T09:10:06Z | - |
dc.date.issued | 2016 | - |
dc.identifier.citation | Heart Rhythm, 2016, v. 13 n. 2, p. 366-373 | - |
dc.identifier.issn | 1547-5271 | - |
dc.identifier.uri | http://hdl.handle.net/10722/227375 | - |
dc.description.abstract | BACKGROUND: Little is known about the clinical benefit of a non-vitamin K antagonist oral anticoagulant compared with warfarin in elderly Chinese patients with atrial fibrillation (AF). OBJECTIVE: The purpose of this study was to evaluate the clinical benefit of dabigatran in elderly (age >/=80 years) Chinese patients with nonvalvular AF with regard to the risk of ischemic stroke and intracranial hemorrhage (ICH). METHODS: This was an observational study. RESULTS: We studied 571 Chinese patients (mean age 84.8 +/- 4.0 years; 58.1% women) with nonvalvular AF. The primary outcome was hospital admission for ischemic stroke, and the secondary outcome was admission for ICH. The mean CHA2DS2-VASc (congestive heart failure [1 point], hypertension [1 point], age 65-74 years [1 point] and age >/=75 years [2 points], diabetes mellitus [1 point], prior stroke or transient ischemic attack [2 points], vascular disease [1 point], sex category [female] [1 point]) and HAS-BLED (hypertension [1 point], abnormal renal/liver function [1 point], stroke [1 point], bleeding history [1 point] or predisposition [1 point], labile international normalized ratio [1 point], elderly [age >65 years] [1 point], drugs/alcohol concomitantly [1 point]) scores were 4.8 +/- 1.6 and 2.4 +/- 0.8, respectively. Of 571 patients, 129 (22.6%) were taking dabigatran 110 mg twice daily and the remaining were on warfarin. After a mean follow-up of 2.6 years (a total of 1471 patient-years), ischemic stroke occurred in 83 patients on warfarin (6.9% per year) compared with 4 patients on dabigatran (1.4% per year) (hazard ratio 0.22; 95% confidence interval 0.23-0.67). There were 8 incidences of ICH: 7 in patients on warfarin (0.59% per year) and 1 patient on dabigatran (0.35% per year). Dabigatran was associated with a substantially lower ischemic stroke risk (1.4% per year vs 5.4% per year) and similar ICH risk (0.35% per year vs 0.36% per year) as compared with warfarin with time in therapeutic range (TTR) >/=55%. CONCLUSION: In elderly Chinese patients with AF, this study suggested that dabigatran achieved superior stroke risk reduction and similar risk of ICH compared with warfarin with TTR >/=55%. Dabigatran may be preferable to warfarin in elderly patients with AF for stroke prevention, particularly in those with poor TTR. | - |
dc.language | eng | - |
dc.publisher | Elsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/heartrhythmjournal | - |
dc.relation.ispartof | Heart Rhythm | - |
dc.subject | Atrial fibrillation | - |
dc.subject | Chinese | - |
dc.subject | Dabigatran | - |
dc.subject | Elderly | - |
dc.title | Stroke prevention using dabigatran in elderly Chinese patients with atrial fibrillation | - |
dc.type | Article | - |
dc.identifier.email | Chan, PHM: phmchan@hku.hk | - |
dc.identifier.email | Hai, SHJJ: haishjj@hku.hk | - |
dc.identifier.email | Li, W: lazylwh@hku.hk | - |
dc.identifier.email | Chan, EW: ewchan@hku.hk | - |
dc.identifier.email | Wong, ICK: wongick@hku.hk | - |
dc.identifier.email | Lau, CP: cplau@hkucc.hku.hk | - |
dc.identifier.email | Tse, HF: hftse@hkucc.hku.hk | - |
dc.identifier.email | Siu, DCW: cwdsiu@hkucc.hku.hk | - |
dc.identifier.authority | Chan, PHM=rp01864 | - |
dc.identifier.authority | Hai, SHJJ=rp02047 | - |
dc.identifier.authority | Chan, EW=rp01587 | - |
dc.identifier.authority | Wong, ICK=rp01480 | - |
dc.identifier.authority | Tse, HF=rp00428 | - |
dc.identifier.authority | Siu, DCW=rp00534 | - |
dc.identifier.doi | 10.1016/j.hrthm.2015.09.015 | - |
dc.identifier.pmid | 26392326 | - |
dc.identifier.scopus | eid_2-s2.0-84955735163 | - |
dc.identifier.hkuros | 259693 | - |
dc.identifier.volume | 13 | - |
dc.identifier.issue | 2 | - |
dc.identifier.spage | 366 | - |
dc.identifier.epage | 373 | - |
dc.identifier.isi | WOS:000368351500009 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 1547-5271 | - |