Many patients with an irregular heartbeat, known as atrial fibrillation, are not receiving recommended blood thinning medication they need to prevent strokes, according to a study published today in the Journal of the American College of Cardiology.
People who have atrial fibrillation are at a very high risk for stroke. However, if they take blood thinners known as oral anticoagulants (OACs), it can reduce their risk by two-thirds. Recent clinical trials have also shown that a new type of blood thinner known as a direct oral anticoagulant (DOAC) can be just as–or even more–effective in preventing stroke in these patients.
“When DOACs were first introduced in 2010, there was an increase in use of oral anticoagulation,” said Lucas N. Marzec, MD, the study’s lead author and a clinical cardiac electrophysiologist at the University of Colorado and researcher with the Colorado Cardiovascular Outcomes Research Consortium in Aurora, Colorado. “However, there are still wide disparities in how they are prescribed. For example, we found that patients at the highest risk of stroke were the least likely to be treated with a DOAC.”
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Using data from the National Cardiovascular Data Registry PINNACLE Registry, the researchers looked at 655,000 patients who were treated at cardiology offices for atrial fibrillation. They found that over a nearly seven-year period, overall use of OACs increased only slightly from 52.4 percent to 60.7 percent among patients who fit the guidelines for using an OAC for stroke prevention. This means 4 in 10 atrial fibrillation patients with elevated stroke risk still are not being prescribed these medications.
Previous studies have shown that even those who are prescribed DOACs often get too low a dose or the physicians who prescribe them are not following dosage recommendations. Up to 35 percent of those who get OACs are not getting the recommended amount. Based on the study findings, this translates to potentially hundreds of thousands of preventable strokes happening each year.