title: Gastrointestinal bleeding with dabigatran, a comparative study with warfarin: a multicenter experience.
abstract: OBJECTIVE
  The risk of gastrointestinal (GI) bleeding with dabigatran when compared to warfarin has been controversial in the literature. The aim of our study was to assess this risk with the use of dabigatran.
  
  
  METHODS
  We examined the medical records of patients who were started on dabigatran or warfarin from October 2010 to October 2012. The study was conducted in two hospitals.
  
  
  RESULTS
  A total of 417 patients were included (208 dabigatran vs. 209 warfarin). GI bleeding occurred in 10 patients (4.8%) in the dabigatran group compared to 21 patients (10.1%) in the warfarin group (p=0.0375). Multivariate analysis showed that patients who were on dabigatran for ≤ 100 days had a higher incidence of GI bleeding than those who were on it for >100 days (p=0.0007). The odds of GI bleeding in patients who were on dabigatran for ≤ 100 days was 8.2 times higher compared to those who were on the drug for >100 days. The incidence of GI bleeding in patients >65 years old was higher than in those <65 years old (p=0.0453, OR=3). History of previous GI bleeding was another risk factor for GI bleeding in the dabigatran group (p=0.036, OR=6.3). The lower GI tract was the most common site for GI bleeding in the dabigatran group (80.0% vs. 38.1%, p=0.014).
  
  
  CONCLUSIONS
  The risk of GI bleeding was lower with dabigatran. The risk factors for GI bleeding with dabigatran were the first 100 days, age >65 years, and a history of previous GI bleeding.
authors.forename: Muhammed
authors.initials: M
authors.lastname: Sherid
authors.forename: Humberto
authors.initials: H
authors.lastname: Sifuentes
authors.forename: Samian
authors.initials: S
authors.lastname: Sulaiman
authors.forename: Salih
authors.initials: S
authors.lastname: Samo
authors.forename: Husein
authors.initials: H
authors.lastname: Husein
authors.forename: Ruth
authors.initials: R
authors.lastname: Tupper
authors.forename: Charles
authors.initials: C
authors.lastname: Spurr
authors.forename: Subbaramiah
authors.initials: S
authors.lastname: Sridhar
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy; D000069604:Dabigatran / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D000069604:Dabigatran
keywords: Antithrombins; Dabigatran; Gastrointestinal hemorrhage; Platelet aggregation inhibitors; Warfarin