Are Patients At Risk For Stroke Getting The Wrong Meds?

Patients with heart rhythm problems likely to develop strokes are often incorrectly prescribed aspirin instead of necessary blood-thinning medications.

Researchers realized that although aspirin can prevent clots, blood thinners are better equipped to prevent strokes in the first place.

A study, published in the Journal of the American College of Cardiology, looked at data from more than 500,000 people with atrial fibrillation and found approximately 40% of the patients had received aspirin instead of anticoagulants.

Atrial fibrillation patients are reported to have up to seven times the stroke risk than patients without the condition.

According to Jonathan Hsu, MD, heart specialist at the University of California, San Diego, and lead study author, “By prescribing aspirin, we may be fooling ourselves that the patient may be protected from stroke when this is not the case — blood thinners have been shown to be clearly more effective than aspirin in preventing stroke for atrial fibrillation patients.”

Hsu and colleagues aimed to assess how many atrial fibrillation patients actual received blood thinners and collected their data from a national registry of cardiovascular disease patients from 2008 to 2012.

Group one included 210,000 people who were at least 75 years old and exhibited other risk factors for stroke like congestive heart failure, diabetes, or high blood pressure. Results showed about 38% were given aspirin, while almost 62% got the anticoagulants.

The second group had nearly 295,000 people who were between 65 and 74 years old, of which 40% were treated with aspirin and 60% with anticoagulants.

Interestingly, the researchers reported that in both groups, the patients prescribed aspirin were younger, slightly less overweight, and more likely to be female or have other medical problems like diabetes, hypertension, high cholesterol, coronary artery disease, or a prior heart attack or peripheral artery disease.

Experts did acknowledge potential side effects could explain the limited prescription of blood thinners, since longer-term use of the blood thinner warfarin could increase the risk of severe bleeding and required frequent lab tests and check-ups. Researchers did note newer anticoagulants were associated with fewer cases of serious bleeding.

While people may question why physicians aren’t prescribing blood thinners when needed, the researchers did suggest lack of knowledge, patient compliance, and cost could be some of the main reasons.