Dabigatran should be administered with caution in elderly patients sue to the risk of hemorrhage, mainly extracranial ones.
In patients undergoing ECV, dabigatran (DAB) was similar to warfarin in the rate of stroke and bleeding at one month. to be superior to warfarin with similar risk of major bleeding. (12) At doses of 110 mg b.i.d it has shown to be non-inferior to warfarin with lower risk of bleeding and at doses of 150 mg b.i.d. (11) Dabigatran etexilate is a prodrug that converts to dabigatran, a direct thrombin inhibitor. In the last years, new anticoagulants have been developed and approved for the prevention of AF throm-boembolic events. (8) In patients with >48-hour A F, anticoagulation is recommended for 3 or 4 weeks before attempting electrical cardioversion (ECV) to de-crease the risk of stroke. It is well known that anticoagulant therapy with vitamin K antagonists (VKA) reduces significantly the risk of stroke in patients with non-valvular AF and increased bleeding. (5) Moreover, presence of left atrial thrombus (LAT) detected by transesophageal echocardiography (TEE) is also a po-tent stroke predictor. (3) Age is a significant risk factor both for thromboembolic events, (4) as for major bleeding associated to anticoagulant treatment. Presence of AF is associated with a 5-fold risk of stroke and increased risk of heart failure and mortality. Methods: Patients ≥65 years with persistent AF in planned electrical cardioversion and with DAB (110 mg or 150 mg b.i.d. Objectives: The aim of this study was to evaluate the presence of left atrial thrombus and spontaneous contrast in patients ≥65 years with persistent AF in planned electrical cardioversion, receiving DAB or acenocoumarol (AC) treatment, and to assess the occur-rence of thromboembolic and hemorrhagic events at one-month follow-up. Left atrial thrombus is an important marker of embolism. César Milstein Better Health Care Unitīackground: Dabigatran (DAB) has shown similar efficacy to warfarin in the prevention of embolism in patients with atrial fibrillation (AF), but it should be administered with caution in elderly patients.
César Milstein Better Health Care UnitĢ Coronary Care Unit of Dr.
#Q ES UN CONTRASTE FULL#
† To apply as Full Member of the Argentine Society of Cardiologyġ Cardiology Service of the Dr. MTSAC Full Member of the Argentine Society of Cardiology LEONARDI2, GRACIELA TREJO2, LORENA BALETI1, MARÍA L. CHIRINO NAVARTA†, 1, ROLANDO PALACIOS2, MARIELA S. Presencia de trombo y contraste espontáneo en la aurícula izquierda en pacientes con fibrilación auricular, anticoagulados con dabigatrán y acenocumarolĭANIEL A. Presence of Thrombus and spontaneous Contrast in the left atrium of Patients with atrial Fibrillation anticoagulated with dabigatran and acenocoumarol
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