RE-LY Trial — Dabigatran vs Warfarin in Atrial Fibrillation

The RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial compared dabigatran — a synthetic direct thrombin inhibitor that shares leech hirudin's target but is not derived from it — against warfarin for stroke prevention in atrial fibrillation. The trial (n=18,113) showed that dabigatran 110 mg twice daily was noninferior to warfarin for stroke or systemic embolism (1.53% vs 1.69% per year; relative risk 0.91, 95% CI 0.74-1.11) and that 150 mg twice daily was superior (1.11% per year; relative risk 0.66, 95% CI 0.53-0.82). Hemorrhagic stroke was lower with both doses (0.12% and 0.10% vs 0.38% per year); major bleeding was lower with 110 mg (2.71% vs 3.36% per year) and similar with 150 mg (3.11%).

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