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DeFelipe-Mimbrera A, Cánovas AA, Guillán M, Matute C, Sainz de la Maza S, Cruz A, Vera R, Masjuan J. Dabigatran in secondary stroke prevention: clinical experience with 106 patients. BIOMED RESEARCH INTERNATIONAL 2014; 2014:567026. [PMID: 25133166 PMCID: PMC4123474 DOI: 10.1155/2014/567026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 06/08/2014] [Accepted: 06/25/2014] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Our aim was to analyze our clinical experience with dabigatran etexilate in secondary stroke prevention. METHODS We retrospectively included patients starting dabigatran etexilate for secondary stroke prevention from March 2010 to December 2012. Efficacy and safety variables were registered. RESULTS 106 patients were included, median follow-up of 12 months (range 1-31). Fifty-six females (52.8%), mean age 76.4 (range 50-95, SD 9.8), median CHADS2 4 (range 2-6), CHA2DS2-VASc 5 (range 2-9), and HAS-BLED 2 (range 1-5). Indication for dabigatran etexilate was ischemic stroke in 101 patients and acute cerebral hemorrhage (CH) due to warfarin in 5 (4.7%). Dabigatran etexilate 110 mg bid was prescribed in 71 cases (67%) and 150 mg bid was prescribed in the remaining. Seventeen patients (16%) suffered 20 complications during follow-up. Ischemic complications (10) were 6 transient ischemic attacks (TIA), 3 ischemic strokes, and 1 acute coronary syndrome. Hemorrhagic complications (10) were CH (1), gastrointestinal bleeding (6), mild hematuria (2), and mild metrorrhagia (1), leading to dabigatran etexilate discontinuation in 3 patients. Patients with previous CH remained uneventful. Three patients died (pneumonia, congestive heart failure, and acute cholecystitis) and 9 were lost during follow-up. CONCLUSIONS Dabigatran etexilate was safe and effective in secondary stroke prevention in clinical practice, including a small number of patients with previous history of CH.
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Affiliation(s)
- Alicia DeFelipe-Mimbrera
- Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain
| | - Araceli Alonso Cánovas
- Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain
| | - Marta Guillán
- Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain
| | - Consuelo Matute
- Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain
| | - Susana Sainz de la Maza
- Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain
| | - Antonio Cruz
- Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain
| | - Rocío Vera
- Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain
| | - Jaime Masjuan
- Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain
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