Medicine protects against strokes

Heart palpitations. Shortness of breath. Tiredness. More and more people can recognise the symptoms of atrial fibrillation, which is one of the most common types of heart disease. More than 65,000 Danes live with the disease, leading to a greatly increased risk of strokes, which are also known as apoplexy.

New research shows that patients who take anticoagulant medicine against atrial fibrillation not only reduce the risk of a thrombosis in the brain:

“Our study shows that the anticoagulant medicine also appears to protect the patients who still suffer the misfortune of a stroke. The risk of suffering serious brain damage or death due to a thrombosis in the brain is significantly smaller for the patients with atrial fibrillation who received anticoagulant medicine, compared to those who did not receive the medicine,” says senior research consultant in clinical epidemiology Søren Paaske Johnsen, Aarhus University.

He has carried out the study in collaboration with colleagues from Aarhus University, Aarhus University Hospital, Gentofte Hospital, and Odense University Hospital.

Largest study in the area

Via the Danish National Patient Registers the researchers have followed a total of 11,356 Danes with atrial fibrillation, who were admitted to hospital during the period 2003-2009 after suffering a stroke. The study is the largest of its kind.

“Only 22 percent of the patients were undergoing relevant treatment with anticoagulant medicine when they were admitted with a stroke. With the knowledge we have now about the protective effect of the medicine it is of course important to be particularly aware of the patients who could benefit from treatment with anticoagulant medicine,” says Søren Paaske Johnsen.

Both mortality within 30 days and the degree of brain damage appears to be lower for patients under anticoagulant treatment. Søren Paaske Johnsen emphasises that there are human, healthcare and financial benefits to be gained if brain damage can be reduced

More people should be treated

That only a minority of patients with atrial fibrillation are treated with anticoagulant medicine could be due to the fact that the treatment will increase the risk of suffering a brain haemorrhage for a minority of patients:

“Treatment with anticoagulant medicine balances on a bit of a razor’s edge, as we know that it will help a large group of patients, but at the same time can give side-effects in the form of brain haemorrhages for a small group. But research, including our latest study, clearly shows that there may be great benefits to be gained by not being quite as cautious with the medicine as we have been previously,” says Søren Paaske Johnsen, and adds:

“This is very much about finding the patients who will benefit most from the anticoagulant medicine. Fortunately there are good clinical tools available, where we look at the patient’s age, previous heart disease and other relevant factors.”

The study has just been published in the respected international journal Stroke - Journal of the American Heart Association.

Facts

• 65,000 people today live with atrial fibrillation, which is one of the most common types of heart disease.
• 13,000 Danes are admitted to hospital annually with apoplexy, which is the third most frequent cause of death in Denmark.
• 15-20 percent of all apoplexy patients have prior atrial fibrillation.
• Atrial fibrillation is an irregular heart rhythm
• The disease primarily afflicts people over 50 years of age.

Read more

The scientific article can be downloaded here:

http://stroke.ahajournals.org/content/early/2013/11/26/STROKEAHA.113.001792.long

Further information

Søren Paaske Johnsen, Senior Research Consultant, Clinical Associate Professor, PhD
Aarhus University and Aarhus University Hospital, Department of Clinical Epidemiology
Tel.: +45 8716 8115 / Mobile: +45 3022 8469
spj@dce.au.dk