Effectiveness and safety of dabigatran etexilate and warfarin in anticoagulant therapy for elderly patients with non-valvular atrial fibrillation

Yin Qiyun; Hu Taohong

doi:10.3760/j.issn.1673-4777.2019.06.008

Abstract：Objective To compare the effectiveness and safety between dabigatran etexilate and warfarin in anticoagulant treatment for elderly patients with non-valvular atrial fibrillation.Methods A total of 110 elderly patients with non-valvular atrial fibrillation admitted to Chinese Medicine Hospital of Mentougou District,Beijing from January 2016 to December 2017 were randomly assigned to dabigatran etexilate group and warfarin group,with55 patients in each group.The dabigatran etexilate group took dabigatran etexilate 150 mg twice per day.The warfarin group took warfarin 3 mg once per day initially with dose adjusted according to the international normalized ratio.All patients were followed up for 1 year;incidences of thromboembolism and bleeding events were analyzed.Results During follow-up,thromboembolism occurred in 3 cases(5.5％) in dabigatran etexilate group,including 1 case of ischemic stroke and 2 cases of lower extremity venous embolism;4 cases(7.3％) in warfarin group had thromboembolism,including 1 case of ischemic stroke and 3 cases of lower extremity venous embolism.There was no significant difference of the incidence of thromboembolism between groups(x2 =0.150,P =0.080).There were 5 cases (9.1％) of bleeding events in dabigatran etexilate group,including 1 case of gastrointestinal hemorrhage,2 cases of subcutaneous hemorrhage and 2 cases of gingival hemorrhage.Warfarin group had 18 cases (32.7％) of bleeding events,including 1 case of cerebral hemorrhage,3 cases of gastrointestinal hemorrhage,5 cases of subcutaneous hemorrhage,4 cases of epistaxis and 5 cases of gingival hemorrhage.Incidence of bleeding events in dabigatran etexilate group was significantly lower than that in warfarin group (x2 =4.758,P =0.026).Conclusion Dabigatran etexilate shows comparable effectiveness and better safety compared to warfarin in longterm anticoagulant therapy for elderly patients with non-valvular atrial fibrillation.