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Stopping Blood Thinners Raises Stroke Risk for Patients With Irregular Heartbeat
Date:4/25/2012

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, April 25 (HealthDay News) -- When patients with atrial fibrillation stop taking anti-clotting drugs, their stroke risk goes up quickly, new research finds.

That risk increases about the same whether they are taking warfarin or a newer, more expensive drug, Xarelto (rivaroxaban).

Atrial fibrillation is an abnormal heart rhythm in which the upper chambers of the heart quiver or flutter instead of contracting correctly, raising the risk of stroke fivefold. Patients are often put on anti-clotting drugs to ward off stroke.

But some people need to temporarily stop taking anti-clotting drugs before surgery or other medical procedures to prevent excess bleeding, while other patients permanently stop taking anti-clotting drugs because of side effects, researchers said.

Researchers analyzed data from a previous trial including more than 14,000 patients with atrial fibrillation. In that trial, rivaroxaban was found to be as effective as warfarin in preventing stroke and blood clots. Both drugs carried about an equal risk of causing excessive bleeding.

In the new study, researchers concentrated on patients who had stopped taking the drugs, either temporarily or permanently. Regardless of which drug was stopped, the rate of strokes and blood clots went up about the same.

Decisions to halt either warfarin or rivaroxaban should be made carefully, since going off the drugs means the heightened stroke risk associated with atrial fibrillation returns, said lead researcher Dr. Manesh Patel, an assistant professor of medicine at Duke University School of Medicine.

"All anticoagulation decisions in patients with atrial fibrillation require risk benefit analysis, and for patients and physicians periods without anticoagulation coverage should be minimized," Patel said.

The study was to be presented Wednesday at the American Heart Association Emer
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