Efficacy of dabigatran etexilate combined with metoprolol in treatment of elderly ischemic stroke patients with non valvular atrial fibrillation

Jiang Song; Feng Ying; Cheng Hao; Fan Jun-cai

doi:10.3969/j.issn.1672-8157.2025.02.004

Abstract：Objective To investigate the efficacy of dabigatran etexilate combined with metoprolol succinate sustained-release tablets in elderly patients with ischemic stroke(IS)complicated with non-valvular atrial fibrillation.Methods A total of 60 elderly patients with ischemic stroke and non-valvular atrial fibrillation treated in Yingshang County People's Hospital from January 2020 to June 2024 were prospectively enrolled and randomly divided into two groups(with 30 in each group).All patients received routine neurological treatment.The patients in the control group were additionally treated with warfarin+metoprolol succinate sustained-re-lease tablets,while those in the observation group were given metoprolol succinate sustained-release tablets+dabigatran etexilate.Neurological function,coagulation parameters,endothelial function,thromboembolism and adverse reactions were compared be-tween the two groups.Results There was no statistically significant difference in the NIHSS scores,coagulation indexes and endo-thelial function between the two groups before treatment(P>0.05).After treatment,NIHSS scores decreased in both groups and they were lower in the observation group than in the control((9.34±3.59)points vs(13.48±4.61)points)(t=3.881,P<0.05).The prothom-bin time,activited partial thomboplastin time and thrombin time increased in both groups,and the prothombin time,activited partial thomboplastin time and thrombin time of the observation group were higher than those of the control((31.29±4.57)s vs(25.19±3.96)s,(42.57±4.98)s vs(39.17±5.15)s,(32.89±5.19)s vs(29.98±5.23)s)(t=5.525,2.599,2.163,all P<0.05).The homocysteine decreased and flow-mediated dilation increased in both groups,and the observation group had lower homocysteine and higher flow-mediated dilation as compared with the control((12.36±1.54)µmol·L-1 vs(16.98±1.61)µmol·L-1,(5.91±1.20)%vs(5.26±1.06)%)(t=11.358,2.224,both P<0.05).The thromboembolism rate was 0 in the observation group and 6.67%in the control,and the adverse reaction rate was 6.67%in the observation group and 23.33%in the control,showing no statistically significant differences(χ2=2.069,3.268,both P>0.05).Conclusion Dabigatran etexilate combined with metoprolol succinate sustained-release tablets can improve neuro-logical function,coagulation function and endothelial function in elderly patients with ischemic stroke and concurrent non-valvular atrial fibrillation.Meanwhile,it has a low risk of thromboembolism and adverse reactions.