Letter by Reynolds et al Regarding Article, “Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial”

Reynolds, Stephanie; Parra, David; Rosenstein, Robert

doi:10.1161/circulationaha.111.056077

Circulation

2012

DOI: 10.1161/circulationaha.111.056077

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Letter by Reynolds et al Regarding Article, “Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial”

Stephanie Reynolds

David Parra

Robert Rosenstein

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Cited by 5 publications

(1 citation statement)

References 4 publications

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“…Pharmacological reversal of VKA-induced anticoagulation effect can be achieved promptly by substitution of prothrombin complex concentrate (15). Probably, our patient would not have needed blood transfusions if prompt reversal of anticoagulation would have been available, which is not the case for dabigatran (16). The application of fresh frozen plasma was not evidence-based but resulted from despair of the anaesthesiol-ogists.…”

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confidence: 92%

Spontaneous gross haematuria during dabigatran therapy for secondary stroke prevention

Stöllberger¹,

Rakusan²,

Wimpissinger³

et al. 2012

Thromb Haemost

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Letters to the Editor Dear Sirs, Dabigatran is an oral thrombin inhibitor which has been approved for prevention of stroke or embolism in atrial fibrillation (AF) patients as an alternative to vitamin K antagonists (VKAs), based on the results of the RELY trial (1). Dabigatran has been introduced into clinical practice although issues like laboratory monitoring, its use in elderly patients, drug-and food-interactions and an antidote have not been completely clarified (2). Aggressive promotion of the drug has already raised criticism (3). In clinical practice, dabigatran is prescribed to patients with comorbidities that were presumably not present in the RELY trial, as illustrated by the following case. In February 2012, an 85-year-old man was admitted because of gross haematuria and urinary retention. The patient had a history of arterial hypertension for 40 years, AF since 25 years, chronic obstructive pulmonary disease since 12 years, renal failure since 10 years, and a non-disabling lefthemispheric stroke at age 81 years. At age 82 years prostate cancer with osseous metastases was diagnosed, and anti-androgen therapy with leuprorelin started. Because of AF he has been treated with phenprocoumon for eight years. Despite constant international normalised ratio (INR) values between 2.0 and 3.0, the patient suffered from two recurrent non-disabling ischaemic strokes in the territory of the left middle cerebral artery in October 2011. After complete recovery, neurologists switched from

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mentioning

confidence: 92%

Spontaneous gross haematuria during dabigatran therapy for secondary stroke prevention

Stöllberger¹,

Rakusan²,

Wimpissinger³

et al. 2012

Thromb Haemost

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Cross-trial comparisons: A source of confusion, use, or both in the management of patients with atrial fibrillation?

Iyer

Wang

Reiffel

2013

American Heart Journal

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Idarucizumab in Emergent Pericardiocentesis: A Case Report of Dabigatran-Induced Haemopericardium and Cardiac Tamponade

et al. 2022

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Haemopericardium has rarely been described in association with the use of a non-vitamin K antagonist oral anticoagulant. Cardiac tamponade is a life-threatening condition that usually requires urgent pericardiocentesis. Here, the authors report a case of haemopericardium with cardiac tamponade during dabigatran therapy for atrial fibrillation in a patient with chronic coronary syndrome, treated effectively with reversal agent idarucizimab before pericardiocentesis. To the authors’ knowledge, this is only the third report of dabigatran-induced haemopericardium.

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Letter by Reynolds et al Regarding Article, “Risk of Bleeding With 2 Doses of Dabigatran Compared With Warfarin in Older and Younger Patients With Atrial Fibrillation: An Analysis of the Randomized Evaluation of Long-Term Anticoagulant Therapy (RE-LY) Trial”

Cited by 5 publications

References 4 publications

Spontaneous gross haematuria during dabigatran therapy for secondary stroke prevention

Spontaneous gross haematuria during dabigatran therapy for secondary stroke prevention

Cross-trial comparisons: A source of confusion, use, or both in the management of patients with atrial fibrillation?

Idarucizumab in Emergent Pericardiocentesis: A Case Report of Dabigatran-Induced Haemopericardium and Cardiac Tamponade

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