Abstract | BACKGROUND: METHODS: A literature search was performed using multiple databases. Outcomes were (1) major bleeding; (2) minor bleeding; and (3) thromboembolic events. Odds ratios ( ORs) were reported for dichotomous variables. RESULTS: Eleven controlled studies (9 cohorts, 1 randomized controlled trial and 1 case-control study; 3841 patients) were identified. Dabigatran was used in 1463 patients, uninterrupted in 223 and held up to 36 hours in the remainder. No significant differences were noted in major bleeding rates between dabigatran and warfarin groups (1.9% vs. 1.6%; OR, 1.04 [95% confidence interval (CI), 0.51-2.13]; P = 0.92). Cardiac tamponade was observed in 1.4% in dabigatran vs 1.1% in warfarin groups (OR, 1.1; 95% CI, 0.55-2.11; P = 0.82). Similar rates for dabigatran vs. warfarin were reported for minor bleeding (3.8% vs. 4.5%; OR, 0.85; 95% CI, 0.58-1.25; P = 0.40), hematoma (2% vs. 2.7%; OR, 0.67; 95% CI, 0.41-1.08; P = 0.1), and thromboembolic events (0.6% vs. 0.1%; OR, 2.51; 95% CI, 0.78-8.11; P = 0.12). CONCLUSIONS: This meta-analysis suggests that dabigatran and warfarin have similar safety and efficacy overall for periprocedural anticoagulation in patients undergoing radiofrequency atrial fibrillation ablation. Signals were seen favouring dabigatran (for hematomas) and warfarin (for thromboembolic events), but neither was statistically significant because of low event rates. More high-quality data are required to definitively compare the 2 strategies.
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Authors | Mohammed Shurrab, Carlos A Morillo, Sam Schulman, Nitin Kansal, Asaf Danon, David Newman, Ilan Lashevsky, Jeff S Healey, Eugene Crystal |
Journal | The Canadian journal of cardiology
(Can J Cardiol)
Vol. 29
Issue 10
Pg. 1203-10
(Oct 2013)
ISSN: 1916-7075 [Electronic] England |
PMID | 23993352
(Publication Type: Journal Article, Meta-Analysis, Review)
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Copyright | Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Anticoagulants
- Antithrombins
- Benzimidazoles
- beta-Alanine
- Warfarin
- Dabigatran
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Topics |
- Anticoagulants
(therapeutic use)
- Antithrombins
(therapeutic use)
- Atrial Fibrillation
(complications, surgery)
- Benzimidazoles
(therapeutic use)
- Catheter Ablation
- Dabigatran
- Humans
- Perioperative Care
(methods)
- Stroke
(etiology, prevention & control)
- Warfarin
(therapeutic use)
- beta-Alanine
(analogs & derivatives, therapeutic use)
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