Comparison of the effect of age (< 75 vs ≥ 75) on the efficacy and safety of dual therapy (dabigatran + clopidogrel or ticagrelor) vs triple therapy (warfarin + aspirin + clopidogrel or ticagrelor) in patients with atrial fibrillation after percutaneous coronary intervention (from the RE-DUAL PCI trial)
The American Journal of Cardiology Dec 18, 2019
ten Berg JM, Steg PG, Bhatt DL, et al. - Given reduced bleeding events resulting from dabigatran dual therapy (110/150 mg twice daily, plus clopidogrel or ticagrelor) vs warfarin triple therapy (warfarin plus aspirin and clopidogrel or ticagrelor) in patients with atrial fibrillation undergoing percutaneous coronary intervention has been reported in the RE-DUAL PCI trial, with noninferiority in composite thromboembolic events, researchers performed this prespecified analysis to compare risks of first major or clinically relevant nonmajor bleeding event and composite endpoint of mortality, thromboembolic events, or unplanned revascularization between dabigatran dual therapy and warfarin triple therapy in older (≥ 75 years) and younger (< 75 years) patients. For this purpose, they used Cox proportional hazard regression. In older and younger patients, a lowering of bleeding risk was brought about by dabigatran 110 mg dual therapy vs warfarin triple therapy. Younger patients had bleeding risk lowered by dabigatran 150 mg dual therapy vs warfarin triple therapy, while older patients experienced no benefit. As for thromboembolic endpoint, a trend for a higher risk with dabigatran 110 mg dual therapy vs warfarin triple therapy was noted in older patients, whereas younger patients exhibited similar risk. In older and younger patients, a similar thromboembolic risk was noted for dabigatran 150 mg dual therapy vs warfarin triple therapy. Overall, there were differences in the benefits of dabigatran dual therapy between the two age groups, which may assist in dose selection when using dabigatran dual therapy.
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