To the Editor We read with interest the recent article by Hernandez et al1 regarding bleeding risk in patients with atrial fibrillation treated with dabigatran. This work contributes to the ongoing debate regarding optimal anticoagulant use in patients with atrial fibrillation.
In a retrospective cohort design1 of Medicare beneficiaries newly diagnosed as having atrial fibrillation, dabigatran use was associated with a statistically significant increased risk of major (hazard ratio [HR], 1.58) and any bleeding (HR, 1.30), and a decreased risk of intracranial bleeding (HR, 0.32) when compared with warfarin, results that are consistent with those of the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial.2
Liu S, Kim CO, Lucyk SN. Dosage of Dabigatran as a Risk Factor for Bleeding in Atrial Fibrillation. JAMA Intern Med. 2015;175(7):1244-1245. doi:10.1001/jamainternmed.2015.1286