The Effect of Dabigatran Plasma Concentrations and Patient Characteristics on the Frequency of Ischemic Stroke and Major Bleeding in Atrial Fibrillation Patients

“…Unlike the findings in our study, a study by Reilly et al involving 9,183 patients (mainly Caucasians) with 35% of them aged 75 years or above, and 3.8% major bleeding events, has identified age as an independent risk factor for a bleeding event (53). In our cohort of 478 patients (mainly Asians), only 31% aged 75 years or older, but 25 patients (5.2%) reported to have major bleeding events.…”

“…However, dabigatran concentrations as well as Hemoclot and ECA-T trough values determined before the bleeding occurred were significantly higher. This is in accordance with previous findings on association between increased blood concentrations of dabigatran as well as high APTT values and the risk of bleeding [8,9].…”

“…[2, 19] As described above, the majority of dabigatran levels at our institution were drawn in order to detect presence of drug prior to proceeding with procedures and/or operations, but the two values that were checked as outpatients are consistent with published ranges. [6, 12] Our data also confirms the wide inter-patient variability that has been described previously in a small number of studies. [12-14, 18] The retrospective nature of our study depended on the chart documentation of the times the drugs were taken by the patient and, therefore, the peak and trough timing of levels may not be precise; however, this is representative of “real-world” management of anticoagulation in clinical practice.…”