Complications at usage of the new anticoagulant therapy in elderly patients

Abstract

Introduction: New anticoagulant therapy (DOAC) was introduced few years ago. It is an alternative therapy for antagonists of vitamin K (VKA) in prevention and therapy of diseases with different etiology. Despite their advantages, bleeding stays a major complication. The fact is that there are no significant researches on this topic. Aim: To analyze the incidence of bleeding as a complication in patients treated with dabigatran. Material and methods: A retrospective study was conducted including 60 patients older than 65 years with nonvalvular atrial fibrillation treated with anticoagulant therapy. Half of this number was taking dabigatran (examined group) and half was taking warfarin (control group). Apart from demographical and clinical parameters, incidence, type and localization of bleeding was also followed. Results: In the group of patients who were taking dabigatran, in 13.3% of cases bleeding occurred as a complication of therapy. Among them, gastrointestinal bleeding was the most common (75%), but also hematomas on the body occurred (25%) and the therapy was immediately discontinued. In 45% of patients taking warfarin, bleeding was verified as a complication. From that number, 33.5% had gastrointestinal bleeding and epistaxis, 8.6% hematomas and 24.4% hematuria. By comparing these two groups, it can be concluded that incidence of bleeding in the group taking dabigatran was significantly lower than in the group taking warfarin (p = 0.038). Conclusion: In the examined group of patients older than 65, who were taking dabigatran, a significantly lower percentage of bleeding as a complication was noticed, compared to the control group taking VKA.

Keywords

• new anticoagulant therapy
• bleeding
• elderly