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Blood-thinning treatment standards changing for heart patients, new research shows
Date:12/9/2010

CINCINNATIResearchers at the University of Cincinnati (UC) and Massachusetts General Hospital have found that warfarin, a known anticoagulation (blood-thinning) drug, may not be as beneficial to some patients with atrial fibrillation as previously thought.

These findings were published online this week ahead of print in the journal Circulation: Cardiovascular Quality and Outcomes.

Warfarin is commonly prescribed to prevent blood clotting, particularly for patients with atrial fibrillationa type of abnormal heart rhythm.

Mark Eckman, MD, professor of medicine at UC and lead investigator of the study, says that this finding could change the way patients with the heart condition manage stroke risk.

"When considering patient-specific decision making for patients with atrial fibrillation, patients at lower risk of stroke and at high risk of bleeding should not receive oral anticoagulant therapy; patients at higher risk of stroke and at low risk of bleeding should receive anticoagulant therapy," he says. "The more difficult decisions lie in the middle where the risks of stroke and bleeding are more closely balanced. Here lies the so-called 'tipping point.'

"Our goal was to revisit the tipping point in light of more contemporary data suggesting a declining stroke risk for any of the typically defined risk factors. We also wished to explore how the future availability of a new, safer anticoagulant, such as the direct thrombin inhibitor dabigatran, in the United States would impact anticoagulant therapy."

Eckman and researchers used a Markov state transition decision modela mathematical framework for modeling decision-making in situations where outcomes are partly due to chance and partly under the control of a decision makerto analyze the CHADS2 score above which anticoagulation is preferred.

The CHADS2 model is used to estimate stroke risk in patients with atrial fibrillation.

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Contact: Katie Pence
katie.pence@uc.edu
513-558-4561
University of Cincinnati Academic Health Center
Source:Eurekalert

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