Abstract 15977: Patient Characteristics and Outcomes in Low Dose versus Standard Dose Dabigatran
Background: Dabigatran (Dabi) is used in non-valvular atrial fibrillation (AF) to prevent stroke and systemic embolism. To date there is no clinical data on low dose (75 mg BID) Dabi. The purpose of this study is to report clinical characteristic, safety and efficacy outcomes on a group of patients treated with low dose vs. standard dose (150 mg BID) Dabi.
Methods: The list of all patients treated with Dabi from January 1, 2011 to December 31, 2012 was extracted from electronic medical records at one medical center. A systematic review of each patient’s chart was performed by a pharmacist who extracted demographic data, patient comorbidities, and outcomes.
Results: There were a total of 363 patients on Dabi, 27 on low dose and 336 on standard dose. Patients on low dose Dabi were significantly older (82 vs. 71 years p=0.001), had lower creatinine clearance (36.7 vs. 69.3 ml/min p=0.001), higher history of stroke (15% vs 9% p=0.01), higher history of bleeding (37% vs 11% p=0.001), longer duration of therapy (10.4 vs. 8.7 months p=0.01) and higher CHADS2 score (2.75 vs 2.48 p=0.01), respectively. At follow up rates of any bleeding (8% vs 13% p=0.01) and gasterointestinal bleeding (4% vs 6% p=0.01) were lower in the low dose Dabi when compared to the standard dose Dabi. There were 3 strokes, all in the standard dose Dabi.
Conclusions: Based on the results of this single center analysis, low dose Dabi appears to be associated with lower bleeding than standard dose Dabi despite utilization in patients at higher risk of bleeding. Further large-scaled studies are needed to better understand the safety and efficacy of low dose Dabi in patients with non-valvular AF.
- © 2013 by American Heart Association, Inc.