Dabigatran and rivaroxaban in the patients with atrial fibrillation and venous thrombembolism: our first clinical experience

ABSTRACT Background: The new oral anticoagulant drugs (NOAC) have shown promising results in the randomized trials in patients with atrial fibrillation (AF) and venous thromboembolism (VTE). The aim of this study was to assess the efficacy and safety of NOAK in the clinical practice. Methods: We included 1.215 patients, 914 with AF and 301 with VTE, who started NOAC. Data on the management and complications were obtained from the computer program Trombo. Results: Patients with AF were treated with either dabigatran 2x110 mg or 2x150 mg or rivaroxaban 1x15 or 1x20 mg and followed for approximately 6 months. Patients with VTE were treated with rivaroxaban and followed for approximately 4 months. Regarding the NOAC prescribed, there was 21–26% of minor bleeding, 1,2–1,9% of major bleeding and 0,4–0,9% of thromboembolic events in patients with AF. In patients with VTE, 13% of minor and 1% of major bleeding, and 0,3% recurrent VTE were observed. There was 154 periprocedural management of patients with AF on NOACs, 3 patients suffered bleeding (all after polypectomy) and 1 patient suffered thromboembolic event postoperatively. NOAC discontinuation due to adverse events or complication was as expected in treatment with rivaroxaban and higher than expected in treatment with dabigatran. Conclusions: Our first analysis of NOAC use in clinical practice showed acceptable safety and efficacy. Additional measures and cautions will be needed for treatment interruption during surgical procedures and complications.