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Most Patients With Irregular Heartbeat Take Inadequate Blood Thinner Dose
Date:8/28/2008

n -- warfarin -- yet, on the other hand, it remains under-used in people who would benefit most from it," Gladstone said.

The study authors believe that efforts are needed to educate physicians and patients about the benefits of warfarin therapy for those with atrial fibrillation. "This is a public health priority, because atrial fibrillation is one of the most common causes of stroke," Gladstone said. "Many more strokes could be prevented if anti-coagulation therapy were optimized in the population at large."

Dr. Byron Lee, an assistant professor of cardiology at the University of California, San Francisco, thinks part of the problem may owe to the fact that many patients have problems taking warfarin, because it requires blood tests to monitor its effectiveness. Too low a dose is ineffective, while too high a dose can cause internal bleeding. So, patients need to have their warfarin levels measured at least once a month, he said.

"Patients hate taking warfarin, and doctors hate prescribing it," Lee said. "This is mainly because it's a hassle. However, this study confirms that many strokes can be avoided if patients are adequately anti-coagulated. Therefore, both patients and doctors need to do a better job of overcoming the inconvenience of warfarin."

Dr. John Worthington is a stroke physician at Liverpool and Northern Beaches Hospitals at the University of New South Wales in Sydney, Australia, who wrote an accompanying editorial in the journal. He said it's essential for patients with atrial fibrillation to receive warfarin to prevent a stroke.

"Warfarin is usually the best and safest available treatment to prevent stroke in people with atrial fibrillation. Increasing the uptake of warfarin would reduce the risk of death and disability of stroke," he said.

Worthington said patients with AF should ask their doctor why they aren't being prescribed warfarin.

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