Am J Transl Res. 2026 Mar 15;18(3):2100-2113. doi: 10.62347/SUSG7727. eCollection 2026.
ABSTRACT
OBJECTIVES: This study compares the safety of dabigatran versus warfarin in elderly patients with atrial fibrillation and stable coronary artery disease, who face higher stroke and bleeding risks due to anticoagulation needs.
METHODS: This retrospective cohort study included patients aged ≥ 65 years who initiated anticoagulation therapy between June 1, 2021 and June 2, 2024. Patients were divided into dabigatran and warfarin groups. Coagulation functions were assessed at baseline and one month post-treatment. Bleeding events and major adverse cardiovascular events were recorded over the 12-month follow-up. Treatment adherence was evaluated at one and three month intervals.
RESULTS: A cohort of 218 patients was analyzed, with 102 in the dabigatran group and 116 in the warfarin group, showing comparable baseline characteristics. One month post-treatment, activated partial thromboplastin time was higher in the dabigatran group (42.11 vs. 40.89, P=0.007), while D-dimer levels were lower (0.55 vs. 0.58, P=0.003). The annual incidence rates of major bleeding (3.92% vs. 12.93%, P=0.019) and intracranial hemorrhage (0.98% vs. 7.76%, P=0.039) were significantly lower in the dabigatran group. Total bleeding events were also lower in the dabigatran group (16.67% vs. 31.90%, P=0.009). Dabigatran group showed reduced rates of ischemic stroke (0.98% vs. 7.76%, P=0.039) and acute myocardial infarction (1.96% vs. 8.62%, P=0.031). Good compliance at 3 months was higher in the dabigatran group (83.3% vs. 69.8%, P=0.020).
CONCLUSIONS: In senior individuals with atrial fibrillation and stable coronary artery disease, dabigatran is associated with better control of thrombotic activity, lower bleeding risk, and a higher medication compliance compared to warfarin.
PMID:42007131 | PMC:PMC13090913 | DOI:10.62347/SUSG7727