Stroke-Preventing Medications Underutilized in Heart Patients

Atrial fibrillation (AFib) causes rapid heartbeat and raises the likelihood of developing blood clots. These clots can form in the heart and travel to the brain, where they can cause a stroke. About one in seven strokes is caused by AFib.

“For patients with AFib, blood thinners can lower the risk for a stroke,” says Simon Gringut, MD, electrophysiologist, Lehigh Valley Heart and Vascular Institute. “It’s important to talk with your doctor or clinician about which to take and how to take it safely.”

In one study, less than half of individuals with AFib received an anticoagulant, or blood thinner, at discharge. One in five of those people was not on any blood thinner before their stroke.

“There are different blood thinners people can take,” Dr. Gringut explains. Generally, drugs called direct oral anticoagulants – i.e., Eliquis – are recommended to lower stroke risk. Warfarin, an older drug, is at times still used primarily due to cost and for people with mechanical heart valves.

In another study, about 83 percent of participants started but stopped, skipped or decreased their blood thinner dose. Some of the people had a documented reason for not taking the drug correctly, including:

• Risk for bleeding
• Cost concerns
• Believed it was safe to skip doses
• Lack of symptoms

People need to speak about their concerns with their doctor or clinician to ensure they are taking the medicine correctly.

Clots form in a specific portion of the heart, the left atrial appendage, in people who have AFib. Individuals who are experiencing bleeding while on blood thinners can have the left atrial appendage sealed to avoid the need for long-term blood thinners. The WATCHMAN procedure is a minimally

As with most heart conditions, your risk for AFib rises as you get older. Other risk factors include high blood pressure, ischemic heart disease and heart failure. Many people with AFib experience a fluttering or pounding sensation in the chest, along with other symptoms such as:

• Dizziness
• Shortness of breath and anxiety
• Fatigue
• Weakness

AFib doesn’t always cause symptoms, however, so talk with your doctor or clinician about getting checked out if you think you may be at risk. “If you’re diagnosed with AFib, be sure to ask about all your medication options,” Dr. Gringut says.