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

September 21, 2012

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

Mouse studies shed light on how protein controls heart failure

October 18, 2017
A new study on two specially bred strains of mice has illuminated how abnormal addition of the chemical phosphate to a specific heart muscle protein may sabotage the way the protein behaves in a cell, and may damage the way ...

Newborns with trisomy 13 or 18 benefit from heart surgery, study finds

October 18, 2017
Heart surgery significantly decreases in-hospital mortality among infants with either of two genetic disorders that cause severe physical and intellectual disabilities, according to a new study by a researcher at the Stanford ...

Saving hearts after heart attacks: Overexpression of a gene enhances repair of dead muscle

October 17, 2017
University of Alabama at Birmingham biomedical engineers report a significant advance in efforts to repair a damaged heart after a heart attack, using grafted heart-muscle cells to create a repair patch. The key was overexpressing ...

High blood pressure linked to common heart valve disorder

October 17, 2017
For the first time, a strong link has been established between high blood pressure and the most common heart valve disorder in high-income countries, by new research from The George Institute for Global Health at the University ...

Blood cancer gene could be key to preventing heart failure

October 16, 2017
A new study, published today in Circulation, shows that the gene Runx1 increases in damaged heart muscle after a heart attack. An international collaboration led by researchers from the University of Glasgow, found that mice ...

Mitochondrial DNA could predict risk for sudden cardiac death, heart disease

October 11, 2017
Johns Hopkins researchers report that the level, or "copy number," of mitochondrial DNA—genetic information stored not in a cell's nucleus but in the body's energy-creating mitochondria—is a novel and distinct biomarker ...

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.