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Are the newer drugs to treat atrial fibrillation right for you?

Posted on by R. Ward Pulliam, MD

 

If you have atrial fibrillation, one of the main goals of your treatment is to prevent stroke. Warfarin has been the mainstay drug for nearly five decades, but it has to be closely monitored. Now, alternative anticoagulation medications that are a lot easier to take, provide options for people who experience interactions with food or other medications or have trouble achieving a steady dose of warfarin.

In 2012, the U.S. Food and Drug Administration approved the drug apixaban tablets (marketed as Eliquis®). Like warfarin, apixaban and similar newer drugs control how fast your blood clots, which in turn lowers your risk of stroke.

Favorable comparisons for stroke prevention

The newer drugs are more convenient than warfarin—and that’s good news for the millions of people who have going for monthly blood checks, even more frequently in some cases, to see how fast their blood is clotting and keep it within a target range.

Most importantly, the new anticoagulants compare favorably with warfarin in preventing stroke in people whose atrial fibrillation is not caused by a heart valve problem—and that’s about 95% of atrial fibrillation patients.

No need for routine blood testing

Unlike warfarin, there’s no need for routine blood testing to see if the drugs are working and there are no food restrictions. You can take the new drugs with or without food and your dose doesn’t depend on what you eat or other medications you’re taking. Like warfarin, however, they do carry a risk of bleeding.

What is atrial fibrillation?

Atrial fibrillation, an irregular heartbeat that originates in the upper chambers, triggers about 100,000 strokes a year in the United States among the nearly 6 million Americans with the disorder. When the top of the heart doesn’t beat regularly, its pumping action is disrupted; leaving blood in the atria that has a tendency to pool or clot. If a clot breaks off and travels to the brain, a stroke can occur.

Atrial fibrillation itself is not a life-threatening arrhythmia, but the possibility of a stroke – 15% of strokes are due to atrial fibrillation — is a very serious potential complication. We must do everything we can to reduce that risk.

Despite the challenges, warfarin has been with us for a long time and we’re very experienced with its use. But having apixaban and other new anticoagulants gives us excellent alternatives for anyone having trouble achieving a steady dose of warfarin or who has interactions with food and other medications.

If you’re taking warfarin, you may want to discuss these new anticoagulants with your doctor.

 | The Heart Group of Lancaster General Health

R. Ward Pulliam, MD, FACC, is a cardiologist with The Heart Group of Lancaster General Health. A graduate of the University of Mississippi Medical School, Dr. Pulliam completed his internal medicine residency at Emory University and fellowships in cardiovascular disease at Tulane University and electrophysiology at the University of Pennsylvania. His areas of expertise include atrial fibrillation, cardiac ablation, and ventricular tachycardia.

 
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