Navigation Links
Aspirin still overprescribed for stroke prevention in AF
Date:1/28/2014

Sophia Antipolis, 28 January 2014: Aspirin is still overprescribed for stroke prevention in atrial fibrillation (AF) despite the potential for dangerous side effects, according to research published today.

Professor Gregory Y.H. Lip, lead author of the European Society of Cardiology (ESC) study, said: "The perception that aspirin is a safe and effective drug for preventing strokes in AF needs to be dispelled. If anything, you could say that giving aspirin to patients with AF is harmful because it is minimally or not effective at stroke prevention, yet the risk of major bleeding or intracranial haemorrhage is not significantly different to well-managed oral anticoagulation."

He added: "All the contemporary guidelines1 say that aspirin should not be used for the prevention of stroke in patients with AF. And yet our study shows that aspirin is still overprescribed in these patients."

Stroke prevention is central to the management of patients with AF. As the most common cardiac rhythm disorder, AF occurs in 1.5-2% of the general population in the developed world and people over the age of 40 have a 1 in 4 lifetime risk of developing AF.2 Patients with AF have a five-fold risk of stroke, and when they do have strokes they lead to more death and disability.3

Prevention of strokes in patients with AF is based on identification of risk factors.2 Patients with no stroke risk factors (ie. CHA2DS2-VASc score of 0 in males or 1 in females) are considered 'low risk' and do not need any antithrombotic drugs. Patients with one or more risk factors should be offered effective stroke prevention, and thus be given an oral anticoagulant (warfarin or one of the novel oral anticoagulants). The use of aspirin, either alone or in combination with an oral anticoagulant, is not recommended.

The study published online today in the American Journal of Medicine provides the most up-to-date picture of European cardiologists' prescribing of antithrombotic treatment, which includes oral anticoagulation therapy (warfarin and the novel oral anticoagulants) and antiplatelet drugs (mainly aspirin).4 The data are from the EORP Atrial Fibrillation General Pilot Registry of more than 3 100 patients in nine countries.5

Overall the study found that the use of oral anticoagulants has improved over the last decade since the last Euro Heart Survey was performed. Where oral anticoagulation was used, most patients (72%) were prescribed warfarin and just 8% were prescribed a new oral anticoagulant.

Professor Lip said: "Novel oral anticoagulant uptake is still a bit low, probably because of differences in regulatory approval, costs and access to drugs in different countries. But the main point is that overall oral anticoagulant uptake as a whole has improved in the last 10 years."

Aspirin was commonly prescribed, either alone or in combination with an oral anticoagulant, when patients had myocardial infarction or coronary artery disease. The strongest reason to prescribe both drugs was coronary artery disease, which increased the use of combined therapy by more than eight-fold.

Professor Lip said: "Aspirin is still overused for stroke prevention in AF. ESC guidelines say concomitant aspirin should not be given to anticoagulated AF patients with stable vascular disease. The combination of drugs does not reduce cardiovascular events and stroke but does increase the risk of bleeding."

Another worrying finding was that oral anticoagulants were underprescribed in elderly patients, with aspirin alone more commonly prescribed. Professor Lip said: "Elderly patients are at the highest risk for stroke and yet they are given aspirin which is not recommended and potentially harmful. There is a perception that elderly patients do not do well on anticoagulation. But a number of studies now, including BAFTA,6 have shown that in elderly patients warfarin is far superior to aspirin in preventing stroke."

Patients with paroxysmal AF were less likely to receive oral anticoagulation compared to patients with permanent AF. Professor Lip said: "Cardiologists are continuing to underprescribe anticoagulation in paroxysmal AF and the belief that these patients are at less risk is another myth. ESC guidelines say that AF patients with stroke risk factors should receive oral anticoagulation irrespective of the type of AF."

Professor Lip concluded: "Our study of antithrombotic prescribing by cardiologists reveals a positive trend of increasing oral anticoagulant use. But worrying misconceptions and practices remain regarding aspirin, treatment of the elderly and paroxysmal AF."


'/>"/>

Contact: ESC Press Office
press@escardio.org
33-049-294-7756
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. Report says new evidence could tip the balance in aspirin cancer prevention care
2. Aspirin as Effective as Warfarin for Heart Failure: Study
3. Some Diabetics May Not Benefit From Daily Aspirin
4. Aspirin protects against Barretts esophagus
5. Study adds to evidence daily aspirin linked to lower cancer mortality
6. Daily aspirin usage associated with lower cancer mortality
7. Daily Aspirin May Cut Cancer Deaths, Another Study Finds
8. Daily Aspirin May Help Fight Prostate Cancer, But Not Breast Cancer
9. Aspirin may help men with prostate cancer live longer, study suggests
10. Adding Plavix to Aspirin Doesnt Help Guard Against Second Stroke: Study
11. Gene mutation identifies colorectal cancer patients who live longer with aspirin therapy
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... LUIS OBISPO, Calif. (PRWEB) , ... October 13, 2017 , ... ... Alzheimer’s or dementia. However, many long-term care insurance companies have a waiver for care ... is the 90-day elimination period, when the family pays for care, is often waived, ...
(Date:10/13/2017)... ... October 13, 2017 , ... Ellevate Network, the leading ... to advocate for action towards gender equality at their inaugural Summit in New York ... globe, and reached a social audience of over 3 million. To watch the Mobilize ...
(Date:10/13/2017)... ... October 13, 2017 , ... Yisrayl Hawkins, Pastor and ... explains one of the most popular and least understood books in the Holy Scriptures, ... puzzling descriptions that have baffled scholars for centuries. Many have tossed it off as ...
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... ... DevOps and Agile Software Development, has been awarded a contract by the Center ... Purchase Agreement (BPA) aims to accelerate the enterprise use of Agile methodologies in ...
(Date:10/13/2017)... ... October 13, 2017 , ... “America On The Brink”: ... “America On The Brink” is the creation of published author, William Nowers. ... As a WWII veteran, he spent thirty years in the Navy. Following ...
Breaking Medicine News(10 mins):
(Date:10/11/2017)... 2017  BioPharmX Corporation (NYSE MKT: BPMX) researchers were ... innovative way to use nonlinear optical imaging to confirm ... drugs. A ... show how researchers from BioPharmX and the Wellman Center ... a suite of imaging techniques in what is called ...
(Date:10/11/2017)... 2017  True Health, a leader in integrated ... during National Breast Cancer Awareness month to educate ... Research recently published ... more than 10 million American women are at ... or BRCA2 and have not had testing. These mutations ...
(Date:10/10/2017)...  NDS received FDA 510(k) clearance in May 2017 for its ... specifically designed for endoscopy environments. An innovative secondary monitor solution, ZeroWire ... to support the improvement of patient outcomes, procedural efficiency, and the ... ... ...
Breaking Medicine Technology: