Results of the RELY TRIAL

James Douketis, MD, of McMaster University discusses data presented at ISTH 2015 from the RELY trial, a large trial comparing dabigatran and warfarin for stroke prevention in patients with atrial fibrillation. Dr. Douketis’ data focused on evaluating patients requiring urgent surgery as compared to those electing a procedure while on these therapies. Patients requiring an urgent procedure were found to have a 7-fold higher risk of bleeding during the perioperative period. Even though major bleeding rates were high among urgent surgery patients (15-20%), the rates were not significantly different between warfarin and dabigatran-treated patients. This data demonstrate that a patient receiving an anticoagulant therapy and requiring an urgent procedure may have their bleeding risk mitigated. It is estimated that urgent surgeries are necessary in 1-2% of anticoagulated patients per year, and these advances help reduce adverse outcomes in these patients.