Feb 07, 2012
Warfarin Therapy
warfarin
Coumadin®, Marcumar®, Warfarin thins the blood and delays clotting
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Treatments are currently available to protect AF patients from stroke or related complications due to blood clots. The most common and effective treatment is the use of the blood thinning medication Warfarin (Coumadin® or Marcumar®). Despite its proven efficacy, Warfarin therapy is not well-tolerated by patients, has a very narrow therapeutic range and carries a high risk for bleeding complications. Additionally, the effectiveness of Warfarin varies because of interactions with certain foods and medications, thus requiring frequent blood tests and dose adjustments, which can be inconvenient. Even with dose adjustments, patients are outside the therapeutic range up to half the time.2

The problems associated with Warfarin therapy are particularly significant in the elderly population, which has a greater risk of falling and greater challenges with maintaining the therapeutic range. This is of importance since individuals over the age of 75 constitute approximately half of AF-associated stroke patients. When prescribing Warfarin therapy in patients with AF, physicians must weigh the risks of significant bleeding complications and non-compliance issues against the risk of ischemic stroke without Warfarin. Fewer than 50% of the patients eligible for long-term Warfarin are currently being treated either due to noncompliance or tolerance issues.3

With the known disutility of Warfarin, and the questionable effectiveness of aspirin, a device-based solution may provide added protection against migration of blood clots in certain patients with AF.

 

2. Connelly SJ, et al, Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range.  Circulation. 2008;118:2029-2037.

3.  Waldo A L, et al for the NABOR Steering Committee.  Hospitalized patients with atrial fibrillation and a high risk of stroke are not being provided with adequate anticoagulation.  J AM Coll Cardiol.2005;46:1729-1736.

Coumadin is a registered trademark of Bristol-Myers Squibb.  Marcumar is a registered trademark of Roche.
 

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