An estimated 2.2 million Americans suffer from atrial fibrillation (AF), an irregular heartbeat in which the chambers of the heart beat so quickly they can only quiver, according to the American Heart Association. About 15 percent of strokes occur in people with AF due to blood clots that can form from the inconsistent heartbeat.
The Health Science Center’s David G. Sherman, M.D., professor of medicine and chief of the neurology division, and his colleagues evaluated a study called Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM). After following more than 4,000 AF patients for two to six years, the study found that continuing the use of the anticoagulant, warfarin – sold under the brand name Coumadin – could save lives. In fact, it showed that while AF was associated with a 60 percent increase in risk of having a stroke, the use of warfarin was associated with a 69 percent
decrease in stroke risk. The study was featured in the May 23 issue of the
Archives of Internal Medicine.
The study is a large multi-center comparison study of the two strategies for treatment of AF: 1.) rate-control, 2.) or sinus rhythm control therapy (a rhythm-control strategy). It found no difference in the risk of death treated with either of the two therapies. Treatment with warfarin was included in both therapies. The difference was that patients in the sinus rhythm control group could stop warfarin after at least four weeks of maintained sinus rhythm while receiving an anti-arrhythmic drug.
“These data suggest that the beneficial effect of warfarin therapy exists not only for patients experiencing AF, but also for patients who have a history of AF but who are presumably in sinus rhythm,” Dr. Sherman and his colleagues concluded in the journal article. “Anticoagulation therapy should be maintained in patients who have a history of AF and risk factors for stroke, even when the recurrent AF has not been documented.”
To view the full article, click on http://www.archinternmed.com. This study was supported by a contract with the National Heart, Lung, and Blood Institute, National Institutes of Health.
