Low bleeding and thromboembolic risk with continued dabigatran during cardiovascular interventions: the GLORIA-AF study

Sake J. van der Wall (Coresponding Author), Gregory Y.H. Lip, Christine Teutsch, Oskars Kalejs, Philippe Lyrer, Christian Hall, Sergio J. Dubner, Hans Christoph Diener, Jonathan L. Halperin, Chang Sheng Ma, Kenneth J. Rothman, Kristina Zint, Dongmei Zhai, Menno V. Huisman, GLORIA-AF Investigators

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: Prospective data on nonvitamin-K-antagonist oral anticoagulant (NOAC) management during cardiovascular interventions are limited. We therefore evaluated the safety and effectiveness of uninterrupted dabigatran therapy as well as dabigatran management during atrial fibrillation (AF)-cardioversions, AF-ablations, pacemaker implantations and coronary angiography and/or stenting procedures. Method: GLORIA-AF is an international registry programme involving patients with newly diagnosed AF. Dabigatran users were followed for ≤2 years. The primary outcome was occurrence of stroke/systemic embolism and major bleeding ≤8 weeks after a cardiovascular intervention during uninterrupted dabigatran therapy. Results: During the 2-year follow-up, 599 cardiovascular interventions were identified in 479 eligible patients. 412/599 (69%) interventions were performed with uninterrupted dabigatran therapy: 299/354 (84%) AF-cardioversions, 38/89 (43%) AF-ablations, 25/58 (43%) pacemaker implantations, and 50/98 (51%) coronary angiography and/or stenting procedures. During an average follow-up of 8.4 weeks after intervention, one major bleed and one systemic embolic event occurred (risk 0.25% for both outcomes; 95% confidence interval, 0.01%-1.36%). Conclusions: More than two thirds of the interventions were performed with uninterrupted dabigatran therapy, of which most were AF-cardioversions. Uninterrupted dabigatran therapy was associated with low major bleeding and stroke/systemic embolism risk, supporting the favourable safety and effectiveness profile of dabigatran in clinical practice-based settings.

Original languageEnglish
Pages (from-to)75-80
Number of pages6
JournalEuropean Journal of Internal Medicine
Volume91
DOIs
Publication statusPublished - Sept 2021
Externally publishedYes

Keywords*

  • Cardiovascular
  • Dabigatran
  • Interventions
  • Nonvitamin-K-antagonist
  • Oral anticoagulant

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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