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Atrial Fibrillation Health Center

Anti-clotting Drug Warfarin May Be Safe for Elderly

Studies Suggest Warfarin May Be Underused for Patients Over 80
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WebMD Health News
Reviewed by Laura J. Martin, MD

Aug. 31, 2011 (Paris) -- The anti-clotting drug warfarin is safe and beneficial for people aged 80 and over, according to a new report.

But the drug is being prescribed to fewer than half of older people with a heart condition that puts them at high risk of stroke who would benefit from warfarin, a second study suggests.

Atrial fibrillation (AF), a condition characterized by irregular heart rhythms, affects 2.6 million Americans. AF risk increases with age.

People with AF are more likely to suffer a stroke than people without AF. That's because their erratic heartbeats allow blood to pool and form clots in the heart. The clots can travel to the brain and block blood flow, causing a stroke.

One in 10 people over age 80 has AF. That number is likely to increase substantially in the next few years due to the aging of the population, says Daniela Poli, MD, of the Azienda Ospedaliera Universitaria Careggi in Florence, Italy.

"Among people aged 80 to 90, about one-fourth of strokes are attributable to atrial fibrillation," she says.

Bleeding Risk From Warfarin

Studies have shown that warfarin can cut stroke risk by up to 70%, Poli said here at the annual meeting of the European Society of Cardiology. Warfarin is also sold under the brand names Coumadin and Jantoven.

A known side effect of warfarin is dangerous bleeding, and the risk of warfarin-related bleeding increases with age, Poli tells WebMD. As a result, many doctors are reluctant to prescribe it to older patients, she says.

A second study presented at the meeting shows that only 49% of 213 people with AF over 80 were prescribed warfarin.

"But our study demonstrates a low rate of bleeding complications in older patients, suggesting that age in itself should not be considered a reason to forgo warfarin treatment," Poli says.

Warfarin vs. Newer Anti-clotting Drugs

The findings come at a time when newer warfarin alternatives like Eliquis, Pradaxa, and Xarelto and have been approved by the FDA or are awaiting FDA approval, Poli notes.

While studies show they may have advantages over warfarin, there is no information on their use in very old people, she says.

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