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Jun 23, 2014

Warfarin Alternative Safe for Elderly Patients with AFib

Anti-clotting drug rivaroxaban offers an easier way for elderly patients with atrial fibrillation to reduce their stroke risk.

The new drug rivaroxaban offers an easier way for elderly patients with atrial fibrillation to reduce their stroke risk, according to a study published in the American Heart Association’s journal, Circulation.

This study compared the widely used blood thinner warfarin (Coumadin, Jantoven) with the newly-approved rivaroxaban (Xarelto) for the treatment of AFib in elderly patients. Atrial fibrillation is the most common type of abnormal heart rhythm in the United States, affecting roughly 2.7 million Americans. For patients living with AFib, reducing risk of stroke with anti-clotting medication is key. However, taking the most common blood thinner, warfarin, can be a challenge, especially for elderly patients. Warfarin requires close monitoring and frequent dose adjustment to avoid complications, like bleeding. Plus, many elderly patients take medications for other conditions, which can interact with warfarin.

Fortunately, rivaroxaban may offer an easier way for elderly patients with AFib to reduce their stroke risk. Designed to test the safety and efficacy of rivaroxaban, this study included more than 6,200 patients 75 years or older with AFib. Patients were randomly chosen to take warfarin or rivaroxaban as a blood thinner during the study and researchers looked at two key outcomes: risk of stroke and bleeding.

After two years of follow up, researchers found that both drugs were equally as safe and effective in preventing stroke. There were no significant differences in complications among patients taking warfarin vs. rivaroxaban and authors believe that rivaroxaban may be a safe alternative for elderly patients with AFib. Not only is rivaroxaban easier to manage, it may help protect elderly patients against stroke—especially those who can’t take warfarin.

Questions for You to Consider

  • What is atrial fibrillation?

  • Atrial fibrillation is an irregular heart rhythm caused by abnormal, chaotic electrical impulses in the heart’s upper chambers, the atria. These electrical impulses, which interfere with the heart’s natural pacemaker, fire so rapidly the atria cannot beat with a regular rhythm or squeeze out blood effectively. Instead, they merely quiver while the ventricles, the heart’s lower chambers, beat rapidly.
  • Does atrial fibrillation increase stroke risk?
  • Yes. Left untreated, AFib causes a five-fold increase in risk for stroke and doubles the risk of heart-related deaths. However, treatment and medication can help significantly reduce risk of complications.

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