title: Dabigatran in secondary stroke prevention: clinical experience with 106 patients.
abstract: BACKGROUND
  Our aim was to analyze our clinical experience with dabigatran etexilate in secondary stroke prevention.
  
  
  METHODS
  We retrospectively included patients starting dabigatran etexilate for secondary stroke prevention from March 2010 to December 2012. Efficacy and safety variables were registered.
  
  
  RESULTS
  106 patients were included, median follow-up of 12 months (range 1-31). Fifty-six females (52.8%), mean age 76.4 (range 50-95, SD 9.8), median CHADS2 4 (range 2-6), CHA2DS2-VASc 5 (range 2-9), and HAS-BLED 2 (range 1-5). Indication for dabigatran etexilate was ischemic stroke in 101 patients and acute cerebral hemorrhage (CH) due to warfarin in 5 (4.7%). Dabigatran etexilate 110 mg bid was prescribed in 71 cases (67%) and 150 mg bid was prescribed in the remaining. Seventeen patients (16%) suffered 20 complications during follow-up. Ischemic complications (10) were 6 transient ischemic attacks (TIA), 3 ischemic strokes, and 1 acute coronary syndrome. Hemorrhagic complications (10) were CH (1), gastrointestinal bleeding (6), mild hematuria (2), and mild metrorrhagia (1), leading to dabigatran etexilate discontinuation in 3 patients. Patients with previous CH remained uneventful. Three patients died (pneumonia, congestive heart failure, and acute cholecystitis) and 9 were lost during follow-up.
  
  
  CONCLUSIONS
  Dabigatran etexilate was safe and effective in secondary stroke prevention in clinical practice, including a small number of patients with previous history of CH.
authors.affiliation: Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: DeFelipe-Mimbrera
authors.affiliation: Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain.
authors.forename: Araceli
authors.initials: A
authors.lastname: Alonso Cánovas
authors.affiliation: Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Guillán
authors.affiliation: Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain.
authors.forename: Consuelo
authors.initials: C
authors.lastname: Matute
authors.affiliation: Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain.
authors.forename: Susana
authors.identifier: 0000-0001-8605-0049
authors.initials: S
authors.lastname: Sainz de la Maza
authors.affiliation: Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cruz
authors.affiliation: Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain.
authors.forename: Rocío
authors.initials: R
authors.lastname: Vera
authors.affiliation: Stroke Unit, Neurology Department, IRYCIS, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo km 9,100, 28034 Madrid, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Masjuan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001562:Benzimidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000139:chemically induced; D000069604:Dabigatran; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000188:drug therapy* / Q000517:prevention & control*; D015091:beta-Alanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D001562:Benzimidazoles; D015091:beta-Alanine; D000069604:Dabigatran