A recent study held by researchers at California is suggesting that patients who suffer from atrial fibrillation (AF) are receiving the wrong medication and increasing their risks of suffering a stroke.  

130,000 Americans die each year from a stroke, according to the Centers for Disease Control and Prevention (CDC). That equals one American dying every 4 minutes due to a heart failure condition.

According to the study held by the University of California San Diego School of Medicine, patients that suffer from AF are currently being prescribed aspirin as a treatment, instead of the anticoagulants they need. Image Credit: Harvard Health
According to the study held by the University of California San Diego School of Medicine, patients that suffer from AF are currently being prescribed aspirin as a treatment, instead of the anticoagulants they need. Image Credit: Harvard Health

The team of researchers, studied around 500,000 cases of AF patients have stated that more than 1 out of 3 patients are receiving the wrong medication for their condition. The study findings were published on June 20 in the Journal of the American College of Cardiology.

Advising a more suitable treatment

Atrial fibrillation is characterized by an abnormal heart rhythm, with a rapid and irregular beating that can become longer and more constant with time.

AF patients have seven times more possibilities of suffering a stroke when compared to other patients that don’t suffer from the condition.

Patients with Atrial fibrillation, have chaotic electrical impulses in the upper chambers of their hearts and instead of having their arterial walls moving normally, they quiver, what makes it more difficult for blood to move normally and causes blood clots.

Researchers determined that 40 percent of AF patients were being treated with aspirin as the only medication. Yet previous studies had shown anticoagulants, such as warfarin,  had better results in this patients, since it reduced the risks of an obstructed blood vessel thanks to a dislodged clot.

“Despite clear guideline recommendations that patients at risk for stroke that have AF should be given blood thinners, many are not prescribed these lifesaving medications,” said Jonathan Hsu, lead researcher of the study.

According to researchers, prescribing aspirin to patients with AF has a minimal or neutral effect on their stroke risk condition, it might even generate other risks, such as intracranial hemorrhage.

The team of researchers decided to analyze how many patients were actually receiving the medication that they needed for their condition, by collecting different data from a cardiovascular registry from 2008 to 2012.

As depicted in the image above, the difference between a healthy heart's beat and a heart of a person with Atrial Fibrillation. Image Credit: YouTube
As depicted in the image above, the difference between a healthy heart’s beat and a heart of a person with Atrial Fibrillation. Image Credit: YouTube

Investigations were held on a group of 210,000 patients of 75 years and older with several other risks factors for stroke, such as congestive heart failure, diabetes, and high blood pressure. The results showed that 38 percent of the group was under aspirin and 62 percent under anticoagulants.

A group of 295,000 patients between 64 and 74 years-old was  also studied, in which 40 percent were being treated with aspirin and 60 percent with anticoagulants.

Researchers determined that in both investigations, younger, slimmer patients were the most likely to receive aspirins instead of anticoagulants, as well as female patients, with other medical problems such as high cholesterol or prior heart attacks.

The team also found that a third of AF patients in the study, who didn’t suffer from a coronary artery disease were being prescribed with anticoagulants and aspirins. Which increases the risks of over bleeding.

“The high rate of an aspirin-only prescription for AF patients with coronary artery disease and other stroke risk factors is concerning. It appears patients with more risk factors for having a stroke with AF are less likely to get the proper treatment,” said lead author, Hsu.

Guidelines for AF patients

Dr. Jonathan Hsu, along with his team, suggests that the current methods being used by physicians might be dangerous for AF patients, and some doctors might be unaware of guidelines.

Anticoagulants such as Warfarin first appeared on the market 60 years ago, yet many patients believe the drugs are expensive and require higher doctor visits and tests. Suggested Dr. Hsu, to explain why aspirin might be the first prescribed medicine.

The lead author of the study suggests that patients should be more aware of the consequences of the medicines they are prescribed and better guidelines should be designed, in order to offer a sustainable health.

The team of researchers stated their concerns on the use of aspirin as an only treatment since this medication is not sufficient enough to benefit AF patients and prevent them from suffering a stroke.

Stroke prevention

The risks of suffering a stroke are not just related to conditions like AF, other risks include race and ethnicity, black people have twice the possibilities of suffering a stroke than white people, they are also more likely to die of a stroke. Hispanic people are less likely to suffer a stroke than white people and American Indians and Alaska natives are just as likely  as blacks to suffer a stroke. Age of the patients and  geography, also play a leading role.

It has been proven that early action is key to preventing a stroke,  that’s why patients with higher risks should be aware of warning signs and symptoms of suffering a stroke.

According to a survey made by the CDC in 2005, 93 percent of stroke patients recognized numbness as a major sign of a stroke and only 38 percent were conscious of all the symptoms of having a stroke.

Recognizing and taking action over a possible stroke might save the life of the patient, but also leading a healthy lifestyle with the correct medication.

Source: JACC