Dutch stroke study urges greater anticoagulant use
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Dutch doctors called on Sunday for greater use of oral anticoagulants to prevent strokes in people with a common heart arrhythmia.
Atrial fibrillation (AF), a heart flutter, is dangerous because blood pools in the heart, forming clots that can lead to deadly strokes.
Current guidelines recommend that AF patients be treated with drugs to stop this happening, but many doctors are wary of using the anticoagulant pills because they are difficult to monitor and can lead to uncontrolled bleeding.
That physician caution may be costing lives, Ron Pisters and colleagues at the University Hospital Maastricht told the annual European Society of Cardiology congress.
A retrospective study of 1,120 patients admitted with ischemic stroke to their hospital between 2003 and 2006 showed 163 had AF, of which 89 were diagnosed with the condition before admission. Yet only 44 patients in this group, or 49 percent, had received guideline anticoagulant therapy.
Pisters estimated that correct medication could have prevented 25 out of the 89 cases of stroke, although, on the down side, there may have been five more cases of cerebral hemorrhage due to excessive bleeding.
Nonetheless, his study concluded that five times more strokes would be prevented than cases of hemorrhage.
The current mainstay of anticoagulant treatment is warfarin, which is sold by several generic drugmakers and by Bristol-Myers Squibb under the brand name Coumadin.
A number of pharmaceutical companies however have new products in development that appear to reduce significantly the bleeding risk seen with warfarin.
Rivals in the race to produce a better oral anticoagulant include Bayer, Eli Lilly and Co and privately owned German drugmaker Boehringer-Ingelheim.
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