OBJECTIVES

- To compare – in a real-world setting - the frequency of bleeding events, myocardial infarctions and strokes in patients receiving warfarin versus dabigatran for atrial fibrillation.

- To evaluate whether the main results of randomized clinical outcome trials and of a national surveillance system can be replicated by a federated EMR based network for a fraction of their costs and duration.

METHODS : TriNetX, a federated global health research network, was used to analyze electronic medical records (EMR) of > 1 Million patients with atrial fibrillation (ICD10 I48). Patients were included if they started either warfarin or dabigatran between November 2010 and May 2014. Non-rheumatic cardiac valve diseases, kidney transplant status and end stage renal disease were excluded. Events were defined by ICD10 codes after start of therapy: Bleeding by having either one of 23 ICD10 codes describing various cerebral, gastrointestinal, or other hemorrhages, stroke by I63, and myocardial infarction by I21.

RESULTS :