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Date:8/28/2008

Warfarin could cut stroke risk by 67%, but patients and doctors say drug is hard to manage

THURSDAY, Aug. 28 (HealthDay News) -- Only 40 percent of patients with atrial fibrillation, a known risk factor for stroke, who did suffer a stroke were taking the anti-clotting drug warfarin, a new study found.

Among those taking warfarin, 75 percent weren't getting the dose needed to prevent a stroke. And an additional 25 percent were taking medications that were less effective at preventing clots or no medication at all, according to the report by Canadian researchers.

"These are missed opportunities for stroke prevention," lead researcher Dr. David J. Gladstone, a stroke neurologist at the University of Toronto, said in a prepared statement. "Sadly, we frequently see patients admitted to a hospital with a devastating stroke who are known to have atrial fibrillation, yet were either not taking warfarin or were taking a dose that is not therapeutic. We consider these to be potentially preventable strokes."

The findings are published online Aug. 29 in the journal Stroke.

Gladstone's team collected data on 2,135 stroke patients listed in the Registry of the Canadian Stroke Network. Among these patients, 597 were diagnosed with atrial fibrillation, an irregular heartbeat, before their stroke. For these patients, 60 percent of the strokes were disabling, and 20 percent were fatal.

Warfarin, by thinning the blood, helps prevent clots from developing and reduces the risk of stroke by about 67 percent in people with atrial fibrillation (AF). Strokes caused by AF can be more severe than other strokes, and studies have shown that warfarin can reduce the severity of strokes in patients with atrial fibrillation, the researchers said.

It's not clear why the rates of warfarin use were so low, the researchers said. "On one hand, we have an extremely effective and cheap medication for stroke preventio
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