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Be careful to use Dabigatran
As we have recently written, the benefit of Dabigatran as protection against stroke in patients with atrial fibrillation needs to be weighed against a significant (28%) increase in the risk of serious and sometimes fatal bleeding, myocardial infarction and acute coronary syndrome. A review of a number of recent studies showed this to be true across a broad spectrum of patients, especially in the elderly and patients with renal dysfunction:
- Dabigatran Association With Higher Risk of Acute Coronary Events, Ken Uchino, MD; Adrian V. Hernandez, MD, PhD, Arch Intern Med, Vol 172: 397-402.
- Legrand M, Mateo J, Aribaud A, et al. The use of dabigatran in elderly patients. Arch Intern Med 2011; 171:1285-1288.
- Jacobs JM and Stessman J. New anticoagulant drugs among elderly patients. Is caution necessary? Arch Intern Med 2011; 171:1287-1288.
Ask Doctor T. Blog
I have been advised by my primary physician to schedule a cardiac catherization and possible stent placement procedure after having a Nuclear Stress Test with the following "Findings:
The study quality is excellent. There is no transient LV ischemic dilatation noted. The left ventricular...
I have a friend with internal defibulator. can I perform cpr and is it possible for me to get shocked if the debibulator is going off?