1.Safety and Efficacy of Dabigatran Versus Warfarin in Asian Patients With Atrial Fibrillation
Liyana Najwa Inche Mat ; Ooi Qi Wen ; Nurul Natasha Ashikin Johari ; Rooban Raao Subramaniam ; Wan Aliaa Wan Sulaiman ; Hoo Fan Kee ; Chia Peck Kee ; Hamidon Basri
Malaysian Journal of Medicine and Health Sciences 2020;16(No.4):89-95
Introduction: Nonvalvular atrial fibrillation is a common cause of cardioembolic stroke which accounts around
50% of all cardioembolic emboli. Oral anticoagulants remain the main choice of stroke prevention in patients with
atrial fibrillation. Our study is aimed to determine the safety (absence or presence of bleeding events) and efficacy
(absence or presence of ischemic stroke occurrence) of dabigatran versus warfarin for stroke prevention in patients
with nonvalvular atrial fibrillation. Methods: A retrospective audit study was conducted based on past data obtained
from Electronic Hospital Information System (EHIS) records in Serdang Hospital. Our sample was 150 patients with
nonvalvular atrial fibrillation who were at risk of getting stroke and being prescribed with oral anticoagulants either
warfarin or dabigatran from the year 2013 until 2019. Results: Our study showed that there was lesser occurrence
of ischemic stroke in patients from dabigatran group (1.3%) as compared to those in warfarin group (2.7%). There
were also almost 2 times lesser bleeding events in dabigatran group (6.7%) as compared to those in warfarin group
(14.7%). The median of CHA2DS2-VASc Score in warfarin sampled patients (median=3+/-1) was lower than dabigatran sampled patients (median=4+/-1). Conclusion: Both warfarin and dabigatran are effective in preventing stroke
for patients with nonvalvular atrial fibrillation. However, dabigatran is associated with lesser bleeding events with
lower incidence of major bleeds compared to warfarin.