Dabigatran Linked to More Bleeding Events Than Warfarin in Atrial Fibrillation
Dabigatran is associated with greater bleeding risks than warfarin among older adults with atrial fibrillation, according to a retrospective analysis in JAMA Internal Medicine.
Using Medicare data on adults who were newly diagnosed with atrial fibrillation in 2010-2011, researchers compared outcomes in some 1300 who filled prescriptions for dabigatran and 8100 who filled prescriptions for warfarin. During roughly 6 to 7.5 months’ follow-up, dabigatran users had significantly higher bleeding risks than warfarin users in terms of any bleeding (33% vs. 27%), major bleeding (9% vs. 6%), and gastrointestinal bleeding (17% vs. 10%). Intracranial hemorrhage occurred more often with warfarin (0.6% vs. 1.8%).
The risk for major bleeding with dabigatran was particularly high for blacks and patients with chronic kidney disease, while the increased risk for intracranial bleeding with warfarin was limited to those aged 75 and older.
The authors conclude: “Before more evidence is available, dabigatran should be prescribed with caution in high-risk patients