Comparative follow-up results of novel oral anticoagulants in daily practice
İsmail Polat Canbolat1, Erdal Belen2, Ümit Yaşar Sinan3, Murat Başkurt1
1Department of Cardiology, İstanbul Bilim University, İstanbul, Turkey
2Department of Cardiology, Okmeydanı Training and Research Hospital, İstanbul, Turkey
3Department of Cardiology, İstanbul University Institute of Cardiology, İstanbul, Turkey
Keywords: Atrial fibrillation; CHA2DS2-VASc; HAS-BLED score; dabigatran; oral anticoagulation; rivaroxaban.
Objectives: This study aims to examine the patients using dabigatran or rivoraxaban to compare their effectiveness and adverse events.
Patients and methods: Our study includes a total of 174 patients (82 male, 92 female; mean age 70.7±8.8 years), using dabigatran (n=113) and rivoraksaban (n=61), who were admitted to our outpatient clinic consecutively between August 2013 and April 2014. Physical examination was performed, patient history, electrocardiogram and biochemical results were recorded. Bleeding and ischemic stroke risk scores (HAS-BLED and CHA2DS2-VASc scores) were calculated. Patients were followed for adverse events.
Results: Patients were followed for an average of 12.9±2.4 months. The CHA2DS2-VASc scores were non-significant between the two groups (3.60±1.30 for dabigatran vs 3.90±1.22 for rivoraxaban, p>0.05). The patients using rivoraxaban had significantly higher HAS-BLED scores than the patients using dabigatran (2.01±0.95 vs 1.60±0.85, p=0.004). During the follow-up period, 12 of the patients had minor bleeding, two had gastrointestinal bleeding, two had intracranial hemorrhage and seven had ischemic stroke. Adverse events were non-significant between the rivoraxaban and dabigatran using patients (p>0.05 for each).
Conclusion: Bleeding and ischemic stroke are rare adverse effects among all the patients. No significant difference was observed between both of the groups in terms of preventing ischemic stroke. Rivoraxaban can be a better option in the patients with high HAS-BLED score to avoid bleeding.