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In atrial fibrillation -- the most common type of irregular heartbeat -- the heart's upper chambers don't pump blood properly, allowing clots to form that can cause a stroke.
Cleveland Clinic researchers led by Dr. Shikhar Agarwal examined data from more than 32,000 people who took part in eight studies that compared warfarin (Coumadin) with newer anti-clotting medications.
The investigators found that stroke risk was higher among women, the elderly, patients who had a previous stroke or mini-stroke (also known as a transient ischemic attack) and patients who had never taken anti-clotting drugs called vitamin K antagonists.
The study was released online March 26 in advance of publication in an upcoming print issue of the Archives of Internal Medicine.
Newer anti-clotting drugs are available and studies have suggested that some are more effective, safer and easier to use than warfarin, which must be carefully monitored and can have serious side effects, such as bleeding. However, these newer drugs are more expensive, so it's likely that warfarin will continue to be the most widely used drug for patients with atrial fibrillation, Agarwal and colleagues said.
A new, promising era in preventing stroke in atrial fibrillation patients has begun, the authors of an accompanying editorial said.
While newer anti-clotting drugs appear effective, warfarin management has also advanced and provides safe, effective and inexpensive stroke prevention treatment for many patients with atrial fibrillation, according to Dr. Daniel Singer, of Massachusetts General Hospital in Boston, and Dr. Alan Go, of Kaiser Permanente Northern California in Oakland.
These improvements in warfarin therapy will likely slow the final transition to the newer drugs, they suggested.
-- Robert Preidt
Copyright © 2012 HealthDay. All rights reserved.
SOURCE: JAMA/Archives journals, news release, March 26, 2012