Date of Award

2012

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavanagh, PhD, PA-C

Abstract

OBJECTIVE: The objective of this systematic review is to determine whether or not dabigatran 150 mg twice daily is non-inferior to warfarin for the prevention of stroke in those with atrial fibrillation with similar rates of bleeding events.

STUDY DESIGN: Review of 3 English language primary studies. All three trials were randomized controlled trials which were blinded for those receiving dabigatran and un-blinded for those receiving warfarin.

DATA SOURCES: Articles were found using PUBMED and COCHRANE databases.

OUTCOME MEASURED: The primary outcomes of these studies were either incidence of stroke or systemic embolism and/or major bleeding events.

RESULTS:The RE-LY study determined that rates of stroke or systemic embolism were 1.11% per year in the group who received 150 mg of dabigatran twice daily and 1.69% per year in those who received dose adjusted warfarin (CI =95%; P=

CONCLUSION: The systemic review of all three randomized controlled trials indicates that dabigatran 150 mg twice a day is a safe, effective, and more convenient alternative to warfarin to prevent stroke in patients with atrial fibrillation.

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