The differences in efficacy and safety of dabigatran and warfarin in anticoagulant therapy for patients with persistent atrial fibrillation
Wang Wei
Yang Fan
Tian Zhipeng
Li Lijie
Li Jing
Han Bing
Abstract：Objective To evaluate the efficacy and safety of dabigatran and warfarin for anticoagulant therapy in patients with persistent atrial fibrillation. Methods A total of 112 patients with persistent atrial fibrillation who were admitted to the Central Hospital Affiliated to Shenyang Medical College from January 2014 to January 2016 were randomly divided into warfarin group (56 cases) and dabigatran group (56 cases), and the patients were given warfarin and dabigatran for anticoagulant therapy respectively. The treatment target was international normalized ratio (INR) 2~3. The coagulation function before and after treatment was compared between two groups. Kaplan-Meier method was used to draw the survival curve, and the incidence of bleeding and thrombosis in the two groups of patients were analyzed. Results (1) Compared with before treatment, the PT, APTT and INR of the warfarin group were significantly increased after 3 months of treatment, the difference was statistically significant (P<0.05), and the change of TT was not significant (P>0.05). The APTT and INR of the patients in the dabigatran group were significantly increased (P<0.05), and the changes of PT and INR were not significant (P>0.05). After 3 months of treatment, the levels of APTT and TT in the dabigatran group were significantly higher than those in the warfarin group (P<0.05), while the PT and INR were significantly lower than those in the warfarin group (P<0.05). (2) There were 5 cases of thrombosis in the warfarin group (8.93%), and 1 case of thrombosis in the dabigatran group. Log rank test showed no significant difference in the risk of thrombosis between the two groups (HR=0.133, 95%CI:0.014~1.278, P=0.081). (3) The all-cause mortality during follow-up in the warfarin group and the dabigatran group was 5.36% and 1.79%, respectively. Log rank test showed that there was no significant difference in all-cause mortality between the two groups (HR=0.329, 95% CI: 0.046~2.335, P=0.311). (4) There were 5 cases (12.50%) and 2 cases (3.57%) of bleeding events in the warfarin group and the Dabigatran group (χ2=0.610, P=0.435). There were no fatal bleeding events in the patients. There was no significant difference in the incidence of adverse reactions between the two groups (26.79% and 19.64%χ2=0.801, P=0.371). Conclusion The anticoagulant effects of dabigatran in patients with persistent atrial fibrillation is significantly better than those of warfarin. The risk of thrombosis and bleeding events is similar between the two drugs, and there is no significant difference in safety.
Keywords：Atrial fibrillationAnticoagulationDabigatranWarfarinThrombotic events
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1385-1388,1392 )