Undertreatment of common heart condition persists despite rapid adoption of novel therapies

September 21, 2012, Johns Hopkins University Bloomberg School of Public Health

A novel blood thinner recently approved by the FDA, dabigatran (Pradaxa), has been rapidly adopted into clinical practice, yet thus far has had little impact on improving treatment rates for atrial fibrillation. This is according to a new study led by researchers from the Johns Hopkins Bloomberg School of Public Health that examined national trends in oral anticoagulant use. They found that despite rapid adoption of dabigatran for the treatment of atrial fibrillation, a large proportion of patients–two in five–did not receive oral anticoagulant therapy. In addition, although the majority of dabigatran utilization was for its FDA-approved indication, atrial fibrillation, an increasing proportion of use was for off-label indications such as venous thromboembolism. The results are featured in the September 2012 issue of Circulation: Cardiovascular Quality and Outcomes.

"Dabigatran has been briskly adopted into clinical practice since its October 2010 approval for the prevention of stroke among patients with non-valvular ," said G. Caleb Alexander, MD, MS, lead author of the study and a research scientist in the Bloomberg School's Department of Epidemiology. "Between 2007 and 2011, use of the oral anticoagulant declined from approximately 2.1 million quarterly physician visits to approximately 1.6 million visits while since its release, dabigatran use increased from 3.1 percent to 18.9 percent of physician visits where an oral anticoagulant was used."

Using data from the IMS National Disease and Therapeutic Index, a nationally representative audit of ambulatory providers, Alexander and colleagues quantified patterns of oral anticoagulant use among subjects between 2007 and 2011. Focusing on the oral anticoagulant drugs, dabigatran and warfarin, they examined treatment patterns by patient age, provider specialty and common indications for . Pharmacy expenditures for warfarin and dabigatran were quantified using a nationally representative audit of retail, mail order and long-term care pharmacies.

According to the National Institutes of Health, atrial fibrillation is the most common type of arrhythmia and, compared with their counterparts, patients with atrial fibrillation have an increased risk of stroke. Previous research has indicated the use of oral anticoagulants may reduce the risk of thromboembolic events like stroke by up to two-thirds and is especially vital in the prevention of such events among high-risk individuals.

The authors conclude that, "a better understanding of how these therapies are being applied in the real world is an important step in understanding their potential to ultimately improve care."

Explore further: Easy-to-use blood thinners likely to replace Coumadin

Related Stories

Easy-to-use blood thinners likely to replace Coumadin

February 6, 2012
Within a few years, a new generation of easy-to-use blood-thinning drugs will likely replace Coumadin for patients with irregular heartbeats who are at risk for stroke, according to a journal article by Loyola University ...

Dabigatran associated with increased risk of acute coronary events

January 9, 2012
The anticoagulant dabigatran is associated with an increased risk of myocardial infarction (heart attack) or acute coronary syndrome in a broad spectrum of patients when tested against some other medicines, according to a ...

Recommended for you

A nanoparticle inhalant for treating heart disease

January 18, 2018
A team of researchers from Italy and Germany has developed a nanoparticle inhalant for treating people suffering from heart disease. In their paper published in the journal Science Translational Medicine, the group describes ...

Starting periods before age of 12 linked to heightened risk of heart disease and stroke

January 15, 2018
Starting periods early—before the age of 12—is linked to a heightened risk of heart disease and stroke in later life, suggests an analysis of data from the UK Biobank study, published online in the journal Heart.

'Decorated' stem cells could offer targeted heart repair

January 10, 2018
Although cardiac stem cell therapy is a promising treatment for heart attack patients, directing the cells to the site of an injury - and getting them to stay there - remains challenging. In a new pilot study using an animal ...

Two simple tests could help to pinpoint cause of stroke

January 10, 2018
Detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan, research suggests.

Exercise is good for the heart, high blood pressure is bad—researchers find out why

January 10, 2018
When the heart is put under stress during exercise, it is considered healthy. Yet stress due to high blood pressure is bad for the heart. Why? And is this always the case? Researchers of the German Centre for Cardiovascular ...

Heart-muscle patches made with human cells improve heart attack recovery

January 10, 2018
Large, human cardiac-muscle patches created in the lab have been tested, for the first time, on large animals in a heart attack model. This clinically relevant approach showed that the patches significantly improved recovery ...

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.