Studies Show Combination Drugs As A Poor Substitute For Anti-Coagulants In Stroke

by Medindia Content Team on  June 10, 2006 at 9:44 AM Drug News   - G J E 4
Studies Show Combination Drugs As A Poor Substitute For Anti-Coagulants In Stroke
A new study has broken the hopes that a combination of aspirin and another clot-preventing drug might be a better alternative for preventing strokes in people with the abnormal heart rhythm called as 'atrial fibrillation' than the standard therapy, of warfarin.

Canadian researchers have cut short their study after the preliminary results showed that there is a higher incidence of not only of strokes, but also of minor bleeding episodes, in people taking the combination of aspirin and clopidogrel (Plavix), They reported their findings in a report in the June 10 issue of The Lancet.

It was explained that warfarin, an anticoagulant, is effective for preventing clotting and strokes in patients, but is was very hard to manage. Dr. Stuart Connelly, director of the division of cardiology at McMaster University, in Hamilton, Ontario, the study leader said that this trial does not create any new indications for clopidogrel, he explained that atrial fibrillation might cause blood to pool in the heart, that could encourage the formation of clots that can then travel to the brain to cause stroke.

Even though warfarin is a powerful anti-clotting agent the doctors world over have always tried to find and use an alternative. The patients using warfarin had to take frequent blood tests to make sure that the dosage is precisely right, due to the high risk of major bleeding episodes is always present. It was explained that the management of the treatment with warfarin is very difficult.

Dr. Anthony J. Furlan, head of the section of stroke and neurological intensive care at the Cleveland Clinic stated that studies have shown that this is the reason as to why only 50% of the patients with atrial fibrillation were on warfarin therapy. Furlan further stated that due to its risks, doctors typically hesitate to prescribe warfarin to very elderly patients, those prone to falls that might precipitate a bleeding episode and those who are unlikely to follow the strict monitoring regimen.

Dr Furlan also said that the study but confirms that the treatment of choice in the vast majority of patients with atrial fibrillation is warfarin. The study was conducted by comparing more than 6,700 people with atrial fibrillation who took either the standard dose of warfarin or a combination of 75 milligrams of clopidogrel and 75 milligrams to 100 milligrams of aspirin a day. It was found that those taking the combination treatment had a 44 percent higher incidence of stroke and a slightly lower incidence of major bleeding episodes than people taking warfarin.

Both the doctors, Furlan and Connolly said they are now prescribing aspirin for people with atrial fibrillation for those who are not suitable for warfarin treatment. But Connolly explained that this could change, he said that another section of the trail that is still being conducted is comparing the combination of clopidogrel plus aspirin to aspirin alone. Stating that the results are expected by the middle of 2008, he said that there is still no clue as to how the results might develop. Connolly while stating that he believes that the combination will prove to be better than aspirin alone he said that it is his hope and expectation.


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