Review of stroke treatment could save lives

September 30, 2011, University of New South Wales

Doctors are underutilising crucial medication to prevent deadly strokes in those with a common type of heart condition, new research says, leading to fresh calls for a review of current treatment strategies and more research into stroke prevention.

Stroke is Australia's second biggest killer after and is a major cause of disability. A new study of over 26,000 stroke patients, has found those with Atrial Fibrillation (AF) – an irregular heartbeat commonly seen in the elderly – have a mortality rate almost twice that of other stroke patients.

As many as 90 percent of patients with AF-related stroke do not receive appropriate blood-thinning medication at the time of their stroke. Researchers say a number of fatal and disabling strokes could therefore be prevented through the better use of existing anticoagulant medication.

The study, led by researchers from the University of New South Wales and the Ingham Institute, is published this month in the journal Cerebrovascular Diseases.

It found that patients with AF make up one in four of the most common form of stroke (ischaemic stroke). Patients with AF had twice the chance of dying in hospital and had a mortality rate of 40 per cent, one year after their stroke. Such patients also had much longer hospital stays and were more likely to be disabled. "This is the biggest evidence practice gap in cardiovascular health," lead report author and UNSW conjoint Associate Professor, John Worthington, said.

He said doctors are underutilising anticoagulants because of an excessive concern over bleeding risk, despite "robust guidelines" being in place for treating AF patients who are over 65 years old. Anticoagulants 'thin' the blood to help prevent blood clots that cause ischaemic strokes. There is a small risk that patients on anticoagulants will suffer major bleeding, including the risk of a brain haemorrhage.

The paper also highlights the limitations of existing strategies to accurately predict and prevent stroke among younger AF patients, who account for 10 per cent of young strokes in the study as well as 19 per cent of early deaths. For many of these patients, "their first stroke will be their last," Assoc. Prof. Worthington said.

However, 20-30 per cent of young with AF would have been judged as 'low risk' by current practices, and not given anticoagulants. The study calls for "urgent research", with a focus on how to better determine risk in all AF patients and for trials of new and existing anticoagulants in younger AF patients.

Explore further: Atrial fibrillation: New management approaches for the 'new epidemic' in cardiovascular disease

Related Stories

Atrial fibrillation: New management approaches for the 'new epidemic' in cardiovascular disease

June 26, 2011
Despite recent advances in the treatment of heart rhythm disturbances, mortality and morbidity rates associated withy atrial fibrillation (AF) remain "unacceptably high", according to a new report. The report, prepared jointly ...

The big risk factor for stroke that you may not know you have

September 15, 2011
A cardiac condition called atrial fibrillation, the most common cardiac arrhythmia, can increase your risk of stroke by 500 percent. That's why Anne B. Curtis, MD, Charles and Mary Bauer Professor and Chair of the University ...

Recommended for you

New link found between alcohol, genes and heart failure

May 25, 2018
The researchers investigated faulty versions of a gene called titin which are carried by one in 100 people or 600,000 people in the UK.

Study examines the rise of plaque in arteries

May 25, 2018
The accumulation of cholesterol plaques in artery walls can lead to atherosclerosis, or the hardening of arteries that contributes to heart attacks and strokes. In a new study, Yale researchers investigate how plaque cells ...

Low-dose aspirin could help pregnant women with high blood pressure avoid a dangerous condition

May 25, 2018
A daily dose of aspirin could help pregnant women in the first stage of high blood pressure avoid a condition that puts both mother and baby in danger, according to a new study.

Study shows in-home therapy effective for stroke rehabilitation

May 24, 2018
In-home rehabilitation, using a telehealth system and supervised by licensed occupational/physical therapists, is an effective means of improving arm motor status in stroke survivors, according to findings presented by University ...

Surgery involving ultrasound energy found to treat high blood pressure

May 23, 2018
An operation that targets the nerves connected to the kidney has been found to significantly reduce blood pressure in patients with hypertension, according to the results of a clinical trial led in the UK by Queen Mary University ...

New guidelines mean 1 in 3 adults may need blood pressure meds

May 23, 2018
(HealthDay)—One out of every three U.S. adults has high blood pressure that should be treated with medication, under guidelines recently adopted by the two leading heart health associations.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.