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

Genetic analysis links obesity with diabetes, coronary artery disease

November 16, 2018
A Cleveland Clinic genetic analysis has found that obesity itself, not just the adverse health effects associated with it, significantly increases the risk of Type 2 diabetes and coronary artery disease. The paper was published ...

Non-coding genetic variant could improve key vascular functions

November 15, 2018
Atherosclerotic disease, the slow and silent hardening and narrowing of the arteries, is a leading cause of mortality worldwide. It is responsible for more than 15 million deaths each year, including an estimated 610,000 ...

Study of two tribes sheds light on role of Western-influenced diet in blood pressure

November 14, 2018
A South American tribe living in near-total isolation with no Western dietary influences showed no increase in average blood pressure from age one to age 60, according to a study led by researchers at Johns Hopkins Bloomberg ...

Heart failure patients shouldn't stop meds even if condition improves: study

November 13, 2018
(HealthDay)—There's bad news for heart failure patients with dilated cardiomyopathy who'd like to stop taking their meds.

Bypass beats stents for diabetics with heart trouble: study

November 13, 2018
(HealthDay)—People with both diabetes and multiple clogged heart arteries live longer if they undergo bypass surgery rather than have their blood vessels reopened with stents, according to follow-up results from a landmark ...

Kawasaki disease: One disease, multiple triggers

November 12, 2018
Researchers at University of California San Diego School of Medicine, Scripps Institution of Oceanography, and international collaborators have evidence that Kawasaki Disease (KD) does not have a single cause. By studying ...

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.