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The American Heart Association and the American College of Cardiology have released a new directive that encourages the use of new oral anticoagulants in patients with atrial fibrillation. Warfarin should only be prescribed to certain patients. ( Steve Buissinne | pixabay )
The American Heart Association and the American College of Cardiology no longer recommend the use of warfarin, a drug that clears blood, for the treatment of atrial fibrillation.
On Monday, January 28, a new guideline was issued to encourage physicians not to prescribe the drug, except for a selected subgroup of patients with atrial fibrillation. Instead, the guideline recommends the use of new oral anticoagulants (NOACs), which have been developed and approved by the US Food and Drug Administration over the last decade.
NOACs on warfarin
Warfarin, better known under the brand name Coumadin, is still safe for use. The new directive still emphasizes the importance of anticoagulants for patients with atrial fibrillation.
However, experts wish to encourage the use of new oral anticoagulants such as dabigatran, rivaroxaban, apixaban and edoxaban. New oral anticoagulants are more effective at preventing stroke and have fewer side effects that are easier to manage than warfarin.
"In 2014, we recommend the use of warfarin and NOACs, but we have not prioritized one over the other," said Craig January, a cardiologist at the # 39; University of Wisconsin and lead author of the 2014 and 2019 guidelines. "We now say that in some patients, NACOs are better than warfarin."
Safer and easier to manage
Warfarin has been developed for the first time as a rat poison, but since 1954 it has been used to reduce the risk of blood clotting. Although it is often referred to as an anticoagulant, it does not actually thin the blood. The drug blocks the formation of vitamin K-dependent clotting factors, reducing the risk of clotting.
People who use this medicine are regularly checked by blood tests to avoid the risk of clotting or excessive bleeding. The frequency of blood tests increases with age, some people have to take blood once a week.
Newer forms of anticoagulants no longer require the same level of surveillance. Patients taking new oral anticoagulants should only have their renal and hepatic function checked once a year.
Due to lack of research, however, patients who have mechanical heart valves and moderate to severe mitral stenosis should continue to take warfarin.
What is atrial fibrillation?
In the United States, 2.7 to 6.1 million people suffer from some form of atrial fibrillation, the most common type of cardiac arrhythmia. Affected individuals have irregular beats in the upper chamber of the heart.
Symptoms of atrial fibrillation include heart palpitations, dizziness, extreme fatigue, shortness of breath, and chest pain. The disease is more common in people 65 years and older.
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