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Reevaluating the benefits of blood thinners

Daily Dose

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January 16, 2012|By Deborah Kotz

Nearly 2.6 million Americans have an abnormal heart rhythm called atrial fibrillation, which makes them five times more likely to have a stroke. Yet research suggests that about 60 percent of those who wind up having a stroke were not on a blood thinner drug that could have prevented dangerous blood clots from forming in the heart, and significantly reduced their risk.

Doctors’ reluctance to prescribe warfarin and newer blood thinners to those with atrial fibrillation needs to change, says the American College of Physicians Foundation. Last week it kicked off an education campaign with risk assessment worksheets it will send to primary care physicians’ offices to use with patients to help them make decisions about drug therapy.

The campaign is funded by Janssen Pharmaceuticals, which manufacturers the blood thinner drug rivaroxaban (Xarelto).

While patients on warfarin require constant monitoring to ensure their dose is correct, newer blood thinners such as rivaroxaban and dabigatran (Pradaxa) do not trigger frequent fluctuations in the blood, so the same dose can be used from week to week. All blood thinners, however, carry a significant risk of bleeding in the brain and elsewhere in the body - which has made doctors reluctant to prescribe them.

Dr. Barbara Schuster, cochair of the Foundation’s education initiative, said the bleeding risks are outweighed by the stroke reduction benefits in atrial fibrillation patients, who have a 2 to 6 percent yearly stroke risk.