Low bleeding and thromboembolic risk with continued dabigatran during cardiovascular interventions: the GLORIA-AF study.

Autor: van der Wall SJ; Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiology, OLVG Hospital, Amsterdam, the Netherlands. Electronic address: s.j.van_der_wall@lumc.nl., Lip GYH; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Teutsch C; Department of CardioMetabolism and Respiratory Medicine, Boehringer Ingelheim International GmbH, Ingelheim, Germany., Kalejs O; Department of Arrhythmology, Pauls Stradins Clinic University Hospital Pilsonuiela, Riga, Latvia., Lyrer P; Department of Neurology, Universitatsspital Basel, Basel, Switzerland., Hall C; Department of Medical Research, Vestre Viken HF, Honefoss, Norway., Dubner SJ; Clínica y Maternidad Suizo Argentina, Buenos Aires, Argentina., Diener HC; Department of Neurology, University of Duisburg-Essen, Essen, Germany., Halperin JL; Icahn School of Medicine at Mount Sinai, New York, NY, United States., Ma CS; Cardiology Department, Atrial Fibrillation Centre, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Rothman KJ; RTI Health Solutions, Research Triangle Institute, Research Triangle Park, NC, United States., Zint K; Global Epidemiology Department, Boehringer Ingelheim International GmbH, Ingelheim, Germany., Zhai D; Biostatistics and Data Sciences Department, Boehringer Ingelheim Pharmaceuticals Inc., Ridgefield, CT, United State., Huisman MV; Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands.
Jazyk: angličtina
Zdroj: European journal of internal medicine [Eur J Intern Med] 2021 Sep; Vol. 91, pp. 75-80. Date of Electronic Publication: 2021 Jun 11.
DOI: 10.1016/j.ejim.2021.05.020
Abstrakt: Background: Prospective data on nonvitamin-K-antagonist oral anticoagulant (NOAC) management during cardiovascular interventions are limited. We therefore evaluated the safety and effectiveness of uninterrupted dabigatran therapy as well as dabigatran management during atrial fibrillation (AF)-cardioversions, AF-ablations, pacemaker implantations and coronary angiography and/or stenting procedures.
Method: GLORIA-AF is an international registry programme involving patients with newly diagnosed AF. Dabigatran users were followed for ≤2 years. The primary outcome was occurrence of stroke/systemic embolism and major bleeding ≤8 weeks after a cardiovascular intervention during uninterrupted dabigatran therapy.
Results: During the 2-year follow-up, 599 cardiovascular interventions were identified in 479 eligible patients. 412/599 (69%) interventions were performed with uninterrupted dabigatran therapy: 299/354 (84%) AF-cardioversions, 38/89 (43%) AF-ablations, 25/58 (43%) pacemaker implantations, and 50/98 (51%) coronary angiography and/or stenting procedures. During an average follow-up of 8.4 weeks after intervention, one major bleed and one systemic embolic event occurred (risk 0.25% for both outcomes; 95% confidence interval, 0.01%-1.36%).
Conclusions: More than two thirds of the interventions were performed with uninterrupted dabigatran therapy, of which most were AF-cardioversions. Uninterrupted dabigatran therapy was associated with low major bleeding and stroke/systemic embolism risk, supporting the favourable safety and effectiveness profile of dabigatran in clinical practice-based settings.
(Copyright © 2021. Published by Elsevier B.V.)
Databáze: MEDLINE
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