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Atrial Fibrillation Patients With Stroke Risk Often Prescribed Wrong Medicine

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More than one in three patients with a heart problem that can increase risk for stroke are prescribed the wrong medicine.

Findings of a new research have revealed that many atrial fibrillation (AF) patients who have increased risk for stroke are only treated with aspirin instead of the recommended blood-thinning medications such as Xarelto (rivaroxaban) or warfarin.

Atrial fibrillation is often marked by irregular and rapid heart rate that happens when the upper chambers of the heart experience chaotic electrical signals. The irregular heartbeat can result in blood clots forming and traveling to the brain, which can lead to stroke.

Because of the erratic nature of their heartbeat, patients with atrial fibrillation have up to seven times increased risk for stroke compared with those who do not have the condition.

Although aspirin helps prevent molecules in blood platelets from sticking together and forming clots, it is not as efficient as blood thinners when it comes to preventing stroke in atrial fibrillation patients.

Findings of a study involving about 500,000 individuals, however, show that more than a third of patients with atrial fibrillation are treated with aspirin and not anticoagulants.

Jonathan Hsu, from the University of California, San Diego, and colleagues looked at the medical and prescription data of more than 210,000 atrial fibrillation patients who were at least 75 years old and who had risk factors for stroke.

They also performed a secondary analysis on a second set of almost 300,000 younger patients who are also considered at risk for stroke.

Hsu and colleagues found that about 40 percent of patients in both groups were treated with aspirin and about 60 percent were treated with a blood thinner.

The researchers also found that younger patients who were slightly less overweight, more likely to be female or have other medical conditions tend to be prescribed with aspirin.

"In a large, real-world cardiac outpatient population of AF patients with a moderate to high risk of stroke, more than 1 in 3 were treated with aspirin alone without OAC [oral anticoagulation]," the researchers wrote in their study, which was published in the Journal of the American College of Cardiology on June 20.

"Specific patient characteristics predicted prescription of aspirin therapy over OAC."

The limited use of blood thinners can be partly blamed on the possibility of side effects. Long-term use of older anticoagulants is known to increase risk of severe bleeding, especially in patients with high blood pressure, cancer, kidney problems or alcoholism.

The researchers also said that the idea of aspirin by itself being sufficient in preventing stroke could be a driving force.

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