2017 update on the changing use of “blood thinners” for AF

Times have changed in the treatment of patients with atrial fibrillation (AF). First some background: The first of the four pillars of AF care is stroke prevention. The only proven means to protect patients with AF from stroke is use of drugs that block clotting factors–or anticoagulants. Some people call these drugs blood thinners. I don’t. That’s because they don’t thin the blood. They inhibit proteins in the blood that form clots; viscosity of the blood is not affected. Blockade of clotting factors works because static blood in the fibrillating (non-contractile) atria increases the probability of clots, which can break off, travel north and cause stroke. A study just published in the Journal of the American College of Cardiology reported changing patterns in the use of clot-blocking drugs. It was a registry study in which doctors across the world entered patients with AF into a data bank. Then researchers tallied up the number of patients who took the drugs and which type of drugs were used. The major finding of the study is something I see happening in my practice: the choice of clot-blocking drugs is moving strongly away from warfarin (Coumadin) and towards the new oral anticoagulant drugs (NOAC), such as dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (Eliquis). In the registry study, prescriptions for NOAC drugs outnumbered warfarin–48% to 32%. Since this comes up so often, I will offer three reasons for this trend. First is that ...
Source: Dr John M - Category: Cardiology Authors: Source Type: blogs