New study finds antithrombotic therapy has no benefit for low-risk atrial fibrillation patients

March 17, 2017
Findings from a large, community-based study show that antithrombotic therapy doesn't decrease low-risk atrial fibrillation patients' risk of suffering a stroke within five years. In fact, researchers found that low-risk patients fared better without any antithrombotic therapy. Credit: Intermountain Medical Center

Findings from a large, community-based study show that antithrombotic therapy doesn't decrease low-risk atrial fibrillation patients' risk of suffering a stroke within five years. In fact, researchers found that low-risk patients fared better without any antithrombotic therapy.

The new findings from researchers at the Intermountain Medical Center Heart Institute in Salt Lake City will be presented on March 17 at the American College of Cardiology's 66th Annual Scientific Session in Washington, D.C.

Antithrombotic agents are drugs that reduce the formation of . Antithrombotics can be used therapeutically for prevention or treatment of a dangerous blood clots.

The news findings contradict some current standards. For instance, the European Cardiology Society advocates therapy for patients with stroke risk factors as defined by a CHA2DS2 VASc score of 1 or more for men and 2 or more for women.

However, the Intermountain Medical Center Heart Institute study found that low-risk patients—with a CHADS2 score of 0-1 or CHA2DS2 VASc score of 0-2—who received experienced higher rates of stroke and significant bleeding.

CHADS2 is an acronym that helps clinicians recall major , assigning one point for each letter: "C" for congestive heart failure, "H" for high blood pressure, "A" for age 75 or older and "D" for diabetes. "S" stands for stroke and the "2" denotes an extra point is assigned for a previous stroke. CHA2DS2-VASc builds on CHADS2, adding points for being female, being between the ages 65-75 and having vascular disease.

Intermountain Medical Center Heart Institute researcher Victoria Jacobs, PhD, NP, says the use of oral anticoagulation or antiplatelet therapies is controversial in the medical community.

"There is still no consensus regarding the initiation of these therapies in low-stroke risk patients, but findings from our study add important insight into this issue," she said.

The study involved 56,723 patients diagnosed with atrial fibrillation and a CHADS2 scores of 0-1 and CHADS2 VASc scores of 0-2. Patients were divided into groups receiving aspirin, Clopidogrel and Warfarin.

Follow-up after five years showed that 4.6 percent of aspirin-prescribed patients suffered a stroke versus 2.3 percent of those who weren't on it; 17.6 percent of those using aspirin experienced significant bleeding versus 11.5 percent not on it.

Of warfarin-prescribed patients, 5.7 percent suffered a stroke after five years versus 2.6 percent of those not on it; 22.3 percent of warfarin patients experienced significant bleeding versus 12.3 percent not on it.

The study concludes that anticoagulation or antiplatelet therapies don't lower stroke rates in low-risk patients, but rather increase their risk of significant bleeding and death.

"We need more studies enrolling low-risk patients, particularly in randomized, controlled trials to guide providers to optimal therapies for these ," Jacobs said.

Explore further: Most atrial fibrillation patients don't get preventive drug before stroke

Related Stories

Most atrial fibrillation patients don't get preventive drug before stroke

March 14, 2017
More than 80 percent of stroke patients with a history of atrial fibrillation either received not enough or no anticoagulation therapy prior to having a stroke, despite the drugs' proven record of reducing stroke risk, according ...

CHADS2 risk score assigns over one-third of stroke patients to low or intermediate stroke risk

September 1, 2013
The CHADS2 stroke risk scores 0 or 1 assign more than one-third of patients in atrial fibrillation with stroke to low or intermediate risk not mandating oral anticoagulation, according to research presented at ESC Congress ...

Stroke, A-fib recurrence low at one year after AF ablation

December 14, 2016
(HealthDay)—Stroke and atrial fibrillation (AF) recurrence are low one year after AF ablation, according to a study published online Dec. 9 in the Journal of Cardiovascular Electrophysiology.

Innovations in anticoagulation for stroke prevention

June 13, 2012
New scientific findings in anticoagulation for stroke prevention are paving the way for updates to the European Society of Cardiology (ESC) Guidelines for the management of atrial fibrillation.

Atrial fibrillation patients are at increased risk of dementia, regardless of anticoagulation use

November 15, 2016
Atrial fibrillation patients who use the drug, warfarin, to prevent harmful blood clots from forming in their hearts to lower risk of stroke are at higher risk of developing dementia than patients who use warfarin for non-atrial ...

GPs undertreat women with AF

September 1, 2013
General practitioners (GPs) undertreat women with atrial fibrillation (AF), according to research presented at ESC Congress 2013 today by Dr Pierre Sabouret from France. The analysis of more than 15,000 patients showed that ...

Recommended for you

Early study shows shoe attachment can help stroke patients improve their gait

December 14, 2017
A new device created at the University of South Florida – and including a cross-disciplinary team of experts from USF engineering, physical therapy and neurology – is showing early promise for helping correct the signature ...

Scientists rewrite our understanding of how arteries mend

December 13, 2017
Scientists from The University of Manchester have discovered how the severity of trauma to arterial blood vessels governs how the body repairs itself.

Deadly heart rhythm halted by noninvasive radiation therapy

December 13, 2017
Radiation therapy often is used to treat cancer patients. Now, doctors at Washington University School of Medicine in St. Louis have shown that radiation therapy—aimed directly at the heart—can be used to treat patients ...

Ultra-thin tissue samples could help to understand and treat heart disease

December 12, 2017
A new method for preparing ultra-thin slices of heart tissue in the lab could help scientists to study how cells behave inside a beating heart.

Young diabetics could have seven times higher risk for sudden cardiac death

December 12, 2017
Young diabetics could have seven times more risk of dying from sudden cardiac arrest than their peers who don't have diabetes, according to new research.

Research reveals how diabetes in pregnancy affects baby's heart

December 12, 2017
Researchers at the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA have discovered how high glucose levels—whether caused by diabetes or other factors—keep heart cells from maturing ...

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.