Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Atrial Fibrillation Health Center

Font Size

Atrial Fibrillation Stroke 'Tragedy'

Too Many Strokes in Heart-Rhythm Patients Due to Coumadin Undertreatment
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 28, 2008 -- Far too many people with atrial fibrillation, an abnormal heart rhythm, suffer preventable strokes, a University of Toronto study suggests.

The "tragedy" is that Coumadin, an inexpensive blood thinner, could prevent about half of these strokes, yet few high-risk patients get proper treatment, says neurologist David J. Gladstone, MD, PhD.

"On one hand, we have an extremely effective and cheap medication for stroke prevention -- Coumadin -- yet on the other hand it remains under-used in people who would benefit most from it," Gladstone says in a news release.

Gladstone's team at the University of Toronto's Sunnybrook Health Sciences Center looked at 597 patients with atrial fibrillation who suffered a first stroke. Stroke in atrial fibrillation patients is particularly severe, so it's no surprise that 20% of the patients died and 60% suffered disabling strokes.

These patients, because of their age, diabetes, or other factors, were at particularly high risk of stroke. All of them should have been taking Coumadin with blood levels of the drug above 2.0 on a blood-thinness scale called the INR.

But only 10% of these stroke patients had an INR this high. Only 40% of these high-risk patients were getting Coumadin, and nearly 30% weren't getting any blood thinner at all.

The finding galls John Worthington, MBBS, of the University of New South Wales in Sydney, Australia.

"As a stroke specialist at two hospitals and a university, it is frustrating to see people disabled or even dying from avoidable stroke," Worthington tells WebMD. "If we were [giving Coumadin to] all the people that should be on this anticoagulant, we would reduce the amount of fatal and disabling stroke by at least 20% and often more. We have a gap between 20 years of compelling evidence about what we should do and what we actually do in treating the high stroke risk in atrial fibrillation."

This happens in the U.S., too, says Leonardo Tamariz, MD, MPH, assistant professor of medicine at the University of Miami Miller School of Medicine. In a soon-to-be-published study, Tamariz and colleagues found that only half of atrial fibrillation patients were taking Coumadin.

1 | 2 | 3

Today on WebMD

pacemaker next to xray
Ablation, cardioversion, pacemaker, and more.
human brain
What you need to know.
woman doing yoga
Tips for easing stress.
fish and vegetables
How to eat to protect your heart.
Omega 3 Overview Slideshow
At Risk for Heart Disease
Recognizing Womens Heart Symptoms
Simple Steps to Lower Cholesterol

Resolved To Quit Smoking
Lowering Blood Pressure Slideshow
Heart Disease And Ed
Atrial fibrillation

WebMD Special Sections