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Statins and the risk of bleeding in patients taking dabigatran.

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Title: Statins and the risk of bleeding in patients taking dabigatran.
Authors: Ho, Bo‐Lin (AUTHOR), Lin, Ya‐Ju (AUTHOR), Lin, Sheng‐Feng (AUTHOR), Chou, Ping‐Song (AUTHOR), Chen, Chien‐Fu (AUTHOR), Lin, Ruey‐Tay (AUTHOR), Hu, Han‐Hwa (AUTHOR), Chao, A‐Ching (AUTHOR)
Source: Acta Neurologica Scandinavica. May2019, Vol. 139 Issue 5, p455-461. 7p.
Subjects: Antithrombins, Atrial fibrillation, Stroke patients, Multivariate analysis, Risk-taking behavior
Abstract: Objectives: Dabigatran etexilate is a direct thrombin inhibitor that clinicians increasingly prescribe to prevent stroke in patients with non‐valvular atrial fibrillation (NVAF). Clinicians also commonly prescribe statins for primary and secondary prevention of cardiovascular diseases. Little is known about the bleeding risk in patients taking a statin and dabigatran together. The aim of this study was to evaluate the safety and persistence of dabigatran after co‐medication with statins. Materials and Methods: We performed a prospective, multicenter registry study of stroke patients with NVAF who initiated dabigatran therapy within 3 months after a clinically evident ischemic cerebrovascular event between 2013 and 2017. The main outcome measure was symptomatic bleeding after 90, 180, and 360 days. Results: In total, 652 patients (336 statin users, 316 non‐users) were followed for 1 year after dabigatran therapy. Cox multivariate analysis demonstrated that male sex, prior use of aspirin, and concurrent use of an antiarrhythmic drug were associated with a higher risk of bleeding at 360 days. After adjusting time‐dependent covariates, statin users had a significantly lower bleeding risk (adjusted hazard ratio: 0.11, P < 0.001) than non‐users. Kaplan‐Meier analysis indicated that patients prescribed with statins had a higher rate of bleeding‐free survival (P = 0.028). Conclusion: For secondary prevention of stroke in patients with NVAF who are taking dabigatran etexilate, co‐prescription with a statin was associated with a lower risk of bleeding complications. Future research is needed to determine the pharmacological mechanism underlying this effect. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Statins and the risk of bleeding in patients taking dabigatran.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ho%2C+Bo‐Lin%22&quot;&gt;Ho, Bo‐Lin&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lin%2C+Ya‐Ju%22&quot;&gt;Lin, Ya‐Ju&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lin%2C+Sheng‐Feng%22&quot;&gt;Lin, Sheng‐Feng&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Chou%2C+Ping‐Song%22&quot;&gt;Chou, Ping‐Song&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Chen%2C+Chien‐Fu%22&quot;&gt;Chen, Chien‐Fu&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lin%2C+Ruey‐Tay%22&quot;&gt;Lin, Ruey‐Tay&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hu%2C+Han‐Hwa%22&quot;&gt;Hu, Han‐Hwa&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Chao%2C+A‐Ching%22&quot;&gt;Chao, A‐Ching&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Acta+Neurologica+Scandinavica%22&quot;&gt;Acta Neurologica Scandinavica&lt;/searchLink&gt;. May2019, Vol. 139 Issue 5, p455-461. 7p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Antithrombins%22&quot;&gt;Antithrombins&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Atrial+fibrillation%22&quot;&gt;Atrial fibrillation&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Stroke+patients%22&quot;&gt;Stroke patients&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Multivariate+analysis%22&quot;&gt;Multivariate analysis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Risk-taking+behavior%22&quot;&gt;Risk-taking behavior&lt;/searchLink&gt;
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  Data: Objectives: Dabigatran etexilate is a direct thrombin inhibitor that clinicians increasingly prescribe to prevent stroke in patients with non‐valvular atrial fibrillation (NVAF). Clinicians also commonly prescribe statins for primary and secondary prevention of cardiovascular diseases. Little is known about the bleeding risk in patients taking a statin and dabigatran together. The aim of this study was to evaluate the safety and persistence of dabigatran after co‐medication with statins. Materials and Methods: We performed a prospective, multicenter registry study of stroke patients with NVAF who initiated dabigatran therapy within 3&#160;months after a clinically evident ischemic cerebrovascular event between 2013 and 2017. The main outcome measure was symptomatic bleeding after 90, 180, and 360&#160;days. Results: In total, 652 patients (336 statin users, 316 non‐users) were followed for 1&#160;year after dabigatran therapy. Cox multivariate analysis demonstrated that male sex, prior use of aspirin, and concurrent use of an antiarrhythmic drug were associated with a higher risk of bleeding at 360&#160;days. After adjusting time‐dependent covariates, statin users had a significantly lower bleeding risk (adjusted hazard ratio: 0.11, P&#160;&lt;&#160;0.001) than non‐users. Kaplan‐Meier analysis indicated that patients prescribed with statins had a higher rate of bleeding‐free survival (P&#160;=&#160;0.028). Conclusion: For secondary prevention of stroke in patients with NVAF who are taking dabigatran etexilate, co‐prescription with a statin was associated with a lower risk of bleeding complications. Future research is needed to determine the pharmacological mechanism underlying this effect. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1111/ane.13077
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      – Code: eng
        Text: English
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        PageCount: 7
        StartPage: 455
    Subjects:
      – SubjectFull: Antithrombins
        Type: general
      – SubjectFull: Atrial fibrillation
        Type: general
      – SubjectFull: Stroke patients
        Type: general
      – SubjectFull: Multivariate analysis
        Type: general
      – SubjectFull: Risk-taking behavior
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      – TitleFull: Statins and the risk of bleeding in patients taking dabigatran.
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              M: 05
              Text: May2019
              Type: published
              Y: 2019
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