Warfarin remains gold-standard for preventing stroke in patients with heart abnormality
EMBARGO: 00:01H (London time) Friday June 9, 2006. In North America the embargo lifts at 18:30H ET Thursday June 8, 2006.Despite their side effects, treatments like warfarin are still the best way to prevent stroke in patients with atrial fibrillation (an abnormal heart rhythm), according to a paper in this week's issue of The Lancet.
Atrial fibrillation is a common condition, affecting over 1% of the population. Patients with atrial fibrillation have a five times higher stroke risk than those without the abnormality. Treatments that prevent blood from clotting (anticoagulants), such as warfarin, reduce stroke by a third compared to no treatment. Anticoagulants are the current gold-standard treatment to prevent stroke in patients with atrial fibrillation. However, treatment must be monitored and side effects include severe bleeding.
In the ACTIVE W trial, Stuart Connolly (McMaster University, Hamilton, Ontario, Canada) and colleagues assessed whether the combination of aspirin and clopidogrel, was a safe and effective alternative to anticoagulants. The investigators randomly assigned 6707 patients with atrial fibrillation to receive either an anticoagulant or a combination of aspirin and clopidogrel. The trial was stopped early after 2 years due to clear evidence for the superiority of anticoagulants over aspirin plus clopidogrel. The researchers found the risk of stroke was 3.9% per year (165 strokes) for those on warfarin and 5.6% per year (234 strokes) for those on the combined treatment.
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Contact: Dr. Stuart Connolly, Director, Division of Cardiology, McMaster University, 237 Barton St. E., Hamilton Ont. L8L 2X2. T) 905 527 4322 ext 44563 / 905 220 3200 (mobile)
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