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A new type of anticoagulant drug, oral anticoagulants not related to vitamin K, is now recommended as a preferred alternative to warfarin to reduce the risk of stroke badociated with atrial fibrillation (AFib), according to a report. Targeted Day of 2014 American Heart Association / American College of Cardiology / Heartbeat Society Guidelines for the Management of Patients with Atrial Fibrillation.
AFib is a type of irregular heartbeat in the atria or upper chambers of the heart. As the heartbeat is irregular, blood can accumulate and then clot in the atria, especially in the left atrial appendage, a pocket that is part of the anatomy of the upper left chamber of the heart. If clots formed in the left atrium migrate into the blood and reach the brain, a stroke caused by a blocked artery can occur even in people with no obvious symptoms of AFib.
Anticoagulants (anticoagulant medications) have long been recommended to reduce the risk of stroke in patients at increased risk of thromboembolism (blocking a blood vessel through a clot in the bloodstream) and / or a stroke caused by narrowing or blocking the arteries
To reduce the risk of stroke in appropriate AFib patients, a new clbad of anticoagulants known as NACO is now the recommended drug clbad compared to the traditional warfarin drug unless patients present moderate to severe mitral stenosis (narrowing of the mitral valve) or artificial heart valve. NOACs include dabigatran, rivaroxaban, apixaban and edoxaban.
"Patients with AFib are at increased risk of stroke, which can be devastating." The goal of AFibrated patient treatment is to reduce the risk of clot formation in the blood, reducing the risk More scientific studies show that NACOs can be safer for patients because the risk of bleeding is lower and that they can also be more effective at preventing clots. " that warfarin, "said Craig T. January, MD, Ph.D., co-chair of the targeted update released simultaneously by the American Heart Association. newspaper circulation, Journal of the American College of Cardiology and the Heart Rhythm Society, HeartRhythm.
The guidelines rank the recommendations as strong, weak or harmful depending on the quality and quantity of scientific research supporting each recommendation. In recommendations with the highest level of evidence, several randomized controlled trials have reported similar results, while the lowest rated recommendations are based on clinical experience of experts. In addition to the strong recommendation to use NACOs for warfarin for many patients, the new guidelines recommend:
Weight loss in overweight or obese patients. Studies have shown that losing weight can reduce the health risks badociated with AFib, or even reverse it. This can also lower blood pressure (hypertension is often badociated with atrial fibrillation).
New drugs are available to reverse the effect of NACOs (called inversion agents). Although rarely used, these inversion agents are useful in case of signs of severe bleeding caused by a NACO or when a patient under NACO needs emergency surgery.
"IBD patients should talk to their health care provider about any concerns they have about their prescribed medications and find out if weight loss would be beneficial to their health," said January, professor of cardiovascular medicine at the University of Wisconsin in Madison, Wisconsin.
The new guidelines also suggest that NOACs could even be used in people at lower risk of stroke than previously thought. Although evidence for this recommendation is not yet final, recent research is beginning to suggest that the benefits of NOACs to reduce the risk of stroke exceed the risk of taking them, said Jan.
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Material provided by American Heart Association. Note: Content can be changed for style and length.
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