Blood Thinners Now Recommended for People With Irregular Heartbeat

Updated guideline from American Academy of Neurology aims to reduce stroke risk

By Robert Preidt

Monday, February 24, 2014

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MONDAY, Feb. 24, 2014 (HealthDay News) -- People with an irregular heartbeat should take blood thinners to reduce their risk of stroke, an updated American Academy of Neurology (AAN) guideline recommends.

Taking these drugs is especially important for people with irregular heartbeat who have already had a stroke or mini-stroke, experts say.

Irregular heartbeat (atrial fibrillation) is a major risk factor for stroke because it causes blood to remain in the heart's upper chambers, according to the AAN. The blood can then form clots that can escape the heart and travel to the brain and cause a stroke. About 5 percent of people with untreated atrial fibrillation are likely to suffer a stroke within the next year, the neurology group pointed out.

Blood thinners (anticoagulants) are highly effective in preventing strokes, but may cause bleeding and should be used only under close medical supervision, according to the guideline published Feb. 25 in the journal Neurology.

Several new blood thinners have been developed since the last AAN guideline on the topic was released in 1998. These new drugs -- such as dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (Eliquis) -- are at least or more effective than the established drug warfarin and are less likely to cause bleeding in the brain, the new guideline states.

In addition, patients taking the new drugs don't have to undergo the frequent blood tests required by those taking warfarin.

The guideline also says that new blood thinners may be used in many patients with atrial fibrillation who have typically been excluded because they are elderly, have mild dementia or have a moderate risk of falls.

"Of course, doctors will need to consider the individual patient's situation in making a decision whether or not to use anticoagulants, and which one to use, as the risks and benefits can vary for each person," guideline lead author Dr. Antonio Culebras, of SUNY Upstate Medical University in Syracuse, said in an AAN news release.

SOURCE: American Academy of Neurology, news release, Feb. 24, 2014

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