Atrial Fibrillation: Dabigatran and Risk of Myocardial Infarction

Professor Gregory Y.H. Lip MD, FRCP (London, Edinburgh, Glasgow), DFM, FACC, FESCUniversity of Birmingham, Centre for Cardiovascular Sciences, City Hospital Consultant Cardiologist & Professor of Cardiovascular Medicine, Director - Haemostasis Thrombosis & Vascular Biology Unit Birmingham, United KingdomMedicalResearch.com Interview with:
Professor Gregory Y.H. Lip MD, FRCP
Consultant Cardiologist & Professor of Cardiovascular Medicine, Director – Haemostasis Thrombosis & Vascular Biology Unit
Birmingham, United Kingdom


MedicalResearch.com:  What are the main findings of the study?

[GYHL] In this large-scale nationwide cohort study, we found that switching to dabigatran increased the risk of MI compared to continued warfarin usage in the early period after switching. Caution may be warranted especially when switching prior VKA-experienced patients with atrial fibrillation to dabigatran. This risk was not evident in the warfarin-naïve cohort newly started on dabigatran.


MedicalResearch.com:  Were any of the findings unexpected?

[GYHL] Dabigatran may provide less protection against myocardial infarction( MI) than warfarin in patients with atrial fibrillation.

In a nationwide cohort study, we found that switching to dabigatran increased the risk of MI compared to continued warfarin usage in the early period after switching.  This risk was not evident in the warfarin-naïve cohort newly started on dabigatran.

MedicalResearch.com:  What should clinicians and patients take away from your report?

[GYHL] Some caution may be warranted, when switching prior warfarin-experienced patients with atrial fibrillation to dabigatran.

MedicalResearch.com:  What recommendations do you have for future research as a result of this study?

[GYHL] More data from real world post marketing data needed, as well as randomised trials

Citation: 

Myocardial ischemic events in ‘real world’ patients with atrial fibrillation treated with dabigatran or warfarin: A nationwide cohort study.

Larsen TB, Rasmussen LH, Gorst-Rasmussen A, Skjøth F, Rosenzweig M, Lane DA, Lip GY.

Am J Med. 2013 Dec 18. pii: S0002-9343(13)01073-5. doi: 10.1016/j.amjmed.2013.12.005. [Epub ahead of print]

 

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