To the Editor: We welcome the articles by Eikelboom and Hankey1 and Attia and Pearce2 about the use of dabigatran as an alternative to warfarin for prevention of embolic stroke. While it is encouraging that new, effective, anticoagulant agents have been added to the anticoagulant pharmacopoeia, we wish to raise specific concerns about the management of intracranial haemorrhage in patients treated with dabigatran.
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- 1. Eikelboom JW, Hankey GJ. Is there really misuse and abuse of dabigatran? Med J Aust 2013; 198: 358-359. <MJA full text>
- 2. Attia JR, Pearce R. The use, misuse and abuse of dabigatran. Med J Aust 2013; 198: 356-357. <MJA full text>
- 3. Hart RG, Diener HC, Yang S, et al. Intracranial hemorrhage in atrial fibrillation patients during anticoagulation with warfarin or dabigatran: the RE-LY trial. Stroke 2012; 43: 1511-1517.
- 4. Douketis JD, Berger PB, Dunn AS, et al. The perioperative management of antithrombotic therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008; 133 (6 Suppl): 299S-339S.
- 5. Parra MW, Zucker L, Johnson ES, et al. Dabigatran bleed risk with closed head injuries: are we prepared? J Neurosurg 2013; May 1. [Epub ahead of print.]
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