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  • Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin

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Aetiology/Harm
Cohort study
Vitamin K antagonist-experienced patients with a history of stroke/transient ischaemic attack who switched from warfarin to dabigatran increased their rate of recurrent stroke/transient ischaemic attack compared with those on warfarin
  1. John W Eikelboom,
  2. Jackie Bosch
  1. McMaster University, Hamilton General Hospital, Hamilton, Ontario, Canada
  1. Correspondence to : Dr John W Eikelboom, McMaster University, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario, Canada L9K 1H8; eikelbj{at}mcmaster.ca

https://doi.org/10.1136/ebmed-2014-110161

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    Commentary on: Larsen TB, Rasmussen LH, Gorst-Rasmussen A, et al. Dabigatran and warfarin for secondary prevention of stroke in atrial fibrillation patients: a nationwide cohort study. Am J Med 2014;127:1172–8OpenUrlCrossRefPubMed.

    Context

    Randomised trials have shown that patients with atrial fibrillation (AF) who are treated with a non-vitamin K antagonist oral anticoagulant (NOAC), compared with warfarin, have similar or lower rates of stroke and major bleeding, markedly reduced rates of intracranial bleeding and a consistent pattern of reduced mortality.1 Dabigatran 150 mg two times a day is the only NOAC that can significantly reduce ischaemic stroke compared with warfarin and can produce even greater ischaemic stroke reduction in patients with prior stroke.2 European guidelines endorse the preferential …

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    Footnotes

    • Competing interests JWE has received honoraria from Bayer, BI, BMS, Daiichi-Sankyo, Janssen and Pfizer. JB has received honoraria from BMS and Pfizer.

    • Provenance and peer review Commissioned; internally peer reviewed.