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Dabigatran better than warfarin at preventing stroke

By Christian Duffin

Twice daily treatment with dabigatran 150mg can reduce the risk of stroke for patients with all types of atrial fibrillation, when compared to warfarin, new data has shown.

Researchers used data from an international randomised controlled trial featuring 118,113 patients in 44 countries.

Dabigatran reduced the rate of stroke by 30%, 39% and 36% compared with warfarin, for permanent, paroxysmal and persistent atrial fibrillation respectively. A twice daily dose of dagigatran etexilate 110mg was as effective as warfarin and less likely to cause major bleeding.

The results were presented at the American College of Cardiology conference. Dabigatran is currently under review by NICE to see if the use of the drug will be cost-effective for the NHS, and a appraisal is due to be published later this year. It is currently approved only for the prevention of venous thromboembolism following elective hip or knee surgery.

Study leader Professor Greg Flaker, professor of medicine at the University of Missouri, United States, concluded: ‘Stroke risk is similar regardless of the type of non-valvular atrial fibrillation. These data show that dabigatran was associated with lower rates of stroke than warfarin in patients with all three types of atrial fibrillation.'

American College of Cardiology 2011, presented April 3.

Warfarin

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