Background: Patients with atrial fibrillation (AF) and prior stroke are at a very high risk of recurrent stroke. The safety and effectiveness of dabigatran etexilate (dabigatran) for stroke prevention in AF has been shown in randomized trials and numerous database studies. Prospective, long-term data on secondary stroke prevention from clinical practice are less available. This analysis from GLORIA-AF describes outcomes on dabigatran for up to 2 years in patients with or without prior stroke.
Methods: GLORIA-AF is a prospective, global registry of patients with newly diagnosed AF. This analysis describes baseline characteristics, clinical outcomes and event rates in dabigatran-treated patients with and without prior stroke.
Results: Overall, 4873 patients were prescribed dabigatran and 4859 received it for an average of 18.3 months. Patients had either no history of stroke (n=4288), a prior stroke (n=579), or their stroke status was unknown (n=6). Compared with patients without prior stroke, those with prior stroke were older (mean age 72.9 vs 69.8 years), had higher CHA2DS2VASc (mean 5.0 vs 3.0) and HAS-BLED (mean 2.3 vs 1.1) scores, but similar frequency of concurrent antiplatelet therapy (13.8% vs 12.6%). Among patients with prior stroke, the rate of recurrent stroke was 1.53 and major bleeding was 1.05 per 100 patient-years. For patients without a stroke history, the rate of stroke was 0.52 and major bleeding was 0.95 per 100 patient-years.
Conclusion: In clinical practice, major bleeding and stroke rates were low with dabigatran, even among patients with prior stroke, confirming the long-term safety and effectiveness of dabigatran

SAFETY AND EFFECTIVENESS OF DABIGATRAN IN PATIENTS WITH ATRIAL FIBRILLATION WITH AND WITHOUT PRIOR STROKE: DATA FROM THE GLORIA-AF REGISTRY PROGRAM