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A comparison of dabigatran and warfarin for stroke prevention in elderly Asian population with nonvalvular atrial fibrillation: an audit of current practice in Malaysia

Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia with significant morbidity and mortality in relation to thromboembolic stroke. Our study aimed to evaluate the safety and efficacy of dabigatran in stroke prevention in elderly patient with nonvalvular AF with regard to the...

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Main Authors: Yap, Swee Hien, Ng, Yau Piao, Roslan, Aslannif, Jayakhantan, Kolanthaivelu, Koh, Kok Wei, P'ng, Hon Shen, Boo, Yang Liang, Hoo, Fan Kee, Yap, Lok Bin
Format: Article
Language:English
Published: Malaysia Medical Association 2017
Online Access:http://psasir.upm.edu.my/id/eprint/59575/1/A%20comparison%20of%20dabigatran%20and%20warfarin%20for%20stroke%20prevention%20in%20elderly%20Asian%20population%20with%20nonvalvular%20atrial%20fibrillation.pdf
http://psasir.upm.edu.my/id/eprint/59575/
http://www.e-mjm.org/index.html
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spelling my.upm.eprints.595752018-03-09T07:02:59Z http://psasir.upm.edu.my/id/eprint/59575/ A comparison of dabigatran and warfarin for stroke prevention in elderly Asian population with nonvalvular atrial fibrillation: an audit of current practice in Malaysia Yap, Swee Hien Ng, Yau Piao Roslan, Aslannif Jayakhantan, Kolanthaivelu Koh, Kok Wei P'ng, Hon Shen Boo, Yang Liang Hoo, Fan Kee Yap, Lok Bin Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia with significant morbidity and mortality in relation to thromboembolic stroke. Our study aimed to evaluate the safety and efficacy of dabigatran in stroke prevention in elderly patient with nonvalvular AF with regard to the risk of ischemic stroke and intracranial haemorrhage (ICH) in real-world setting. Methods: A retrospective cohort study of 200 patients on dabigatran and warfarin from January 2009 till September 2016 was carried out. Data were collected for 100 patients on dabigatran and 100 patients on warfarin. Results: The mean follow-up period was 340.7±322.3 days for dabigatran group and 410.5±321.2 days for warfarin group. The mean time in therapeutic range (TTR) was 52±18.7%. The mean CHA2DS2 -VASc score for dabigatran group was 4.4±1.1 while 5.0±1.5 for warfarin group. None in dabigatran group experienced ischemic stroke compared to one patient in warfarin group (p=0.316). There was one patient in dabigatran group suffered from ICH compared to none in warfarin group (p=0.316). Four patients in warfarin group experienced minor bleeding, while none from dabigatran group (p=0.043). Conclusion: Overall bleeding events were significantly lower in dabigatran group compared to warfarin group. In the presence of suboptimal TTR rates and inconveniences with warfarin therapy, non-vitamin-K antagonist oral anticoagulants (NOAC) are the preferred agents for stroke prevention in elderly Asian patients for nonvalvular AF. Malaysia Medical Association 2017 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/59575/1/A%20comparison%20of%20dabigatran%20and%20warfarin%20for%20stroke%20prevention%20in%20elderly%20Asian%20population%20with%20nonvalvular%20atrial%20fibrillation.pdf Yap, Swee Hien and Ng, Yau Piao and Roslan, Aslannif and Jayakhantan, Kolanthaivelu and Koh, Kok Wei and P'ng, Hon Shen and Boo, Yang Liang and Hoo, Fan Kee and Yap, Lok Bin (2017) A comparison of dabigatran and warfarin for stroke prevention in elderly Asian population with nonvalvular atrial fibrillation: an audit of current practice in Malaysia. Medical Journal of Malaysia, 72 (6). pp. 360-364. ISSN 0300-5283 http://www.e-mjm.org/index.html
institution Universiti Putra Malaysia
building UPM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Putra Malaysia
content_source UPM Institutional Repository
url_provider http://psasir.upm.edu.my/
language English
description Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia with significant morbidity and mortality in relation to thromboembolic stroke. Our study aimed to evaluate the safety and efficacy of dabigatran in stroke prevention in elderly patient with nonvalvular AF with regard to the risk of ischemic stroke and intracranial haemorrhage (ICH) in real-world setting. Methods: A retrospective cohort study of 200 patients on dabigatran and warfarin from January 2009 till September 2016 was carried out. Data were collected for 100 patients on dabigatran and 100 patients on warfarin. Results: The mean follow-up period was 340.7±322.3 days for dabigatran group and 410.5±321.2 days for warfarin group. The mean time in therapeutic range (TTR) was 52±18.7%. The mean CHA2DS2 -VASc score for dabigatran group was 4.4±1.1 while 5.0±1.5 for warfarin group. None in dabigatran group experienced ischemic stroke compared to one patient in warfarin group (p=0.316). There was one patient in dabigatran group suffered from ICH compared to none in warfarin group (p=0.316). Four patients in warfarin group experienced minor bleeding, while none from dabigatran group (p=0.043). Conclusion: Overall bleeding events were significantly lower in dabigatran group compared to warfarin group. In the presence of suboptimal TTR rates and inconveniences with warfarin therapy, non-vitamin-K antagonist oral anticoagulants (NOAC) are the preferred agents for stroke prevention in elderly Asian patients for nonvalvular AF.
format Article
author Yap, Swee Hien
Ng, Yau Piao
Roslan, Aslannif
Jayakhantan, Kolanthaivelu
Koh, Kok Wei
P'ng, Hon Shen
Boo, Yang Liang
Hoo, Fan Kee
Yap, Lok Bin
spellingShingle Yap, Swee Hien
Ng, Yau Piao
Roslan, Aslannif
Jayakhantan, Kolanthaivelu
Koh, Kok Wei
P'ng, Hon Shen
Boo, Yang Liang
Hoo, Fan Kee
Yap, Lok Bin
A comparison of dabigatran and warfarin for stroke prevention in elderly Asian population with nonvalvular atrial fibrillation: an audit of current practice in Malaysia
author_facet Yap, Swee Hien
Ng, Yau Piao
Roslan, Aslannif
Jayakhantan, Kolanthaivelu
Koh, Kok Wei
P'ng, Hon Shen
Boo, Yang Liang
Hoo, Fan Kee
Yap, Lok Bin
author_sort Yap, Swee Hien
title A comparison of dabigatran and warfarin for stroke prevention in elderly Asian population with nonvalvular atrial fibrillation: an audit of current practice in Malaysia
title_short A comparison of dabigatran and warfarin for stroke prevention in elderly Asian population with nonvalvular atrial fibrillation: an audit of current practice in Malaysia
title_full A comparison of dabigatran and warfarin for stroke prevention in elderly Asian population with nonvalvular atrial fibrillation: an audit of current practice in Malaysia
title_fullStr A comparison of dabigatran and warfarin for stroke prevention in elderly Asian population with nonvalvular atrial fibrillation: an audit of current practice in Malaysia
title_full_unstemmed A comparison of dabigatran and warfarin for stroke prevention in elderly Asian population with nonvalvular atrial fibrillation: an audit of current practice in Malaysia
title_sort comparison of dabigatran and warfarin for stroke prevention in elderly asian population with nonvalvular atrial fibrillation: an audit of current practice in malaysia
publisher Malaysia Medical Association
publishDate 2017
url http://psasir.upm.edu.my/id/eprint/59575/1/A%20comparison%20of%20dabigatran%20and%20warfarin%20for%20stroke%20prevention%20in%20elderly%20Asian%20population%20with%20nonvalvular%20atrial%20fibrillation.pdf
http://psasir.upm.edu.my/id/eprint/59575/
http://www.e-mjm.org/index.html
_version_ 1643837112440586240
score 13.211869

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