Blood-thinning drug reduces stroke risk

According to a new study, a blood-thinning drug could save both lives and money.

For people like 67-year-old Eugene Masters, the treatment might be just what they've been looking for. Masters is on the mend after a 1986 heart attack. Two years ago, he developed a rapid irregular heart beat called atrial fibrillation. Ever since, he's taken a drug called Warfarin, also known as Cumadin, to reduce the possibility of a stroke. The drug thins the blood, lessening the chance a clot will form. Masters has been stroke-free, and is very pleased with the drug. His doctor agrees.

"For atrial fibrillation, the use of Warfarin in a majority of those patients reduces the chance of having a stroke by about two-thirds," says Dr. Richard Katz of George Washington University. "So it's a very effective therapy."

The U.S. Agency for Healthcare Policy and Research also believes in Warfarin. It has even taken the unprecedented action of releasing a study of the drug early. Researchers have found that roughly 5 percent of the population over the age of 65 have a condition that if properly treated, would reduce their risk of stroke by over half. Some scientists are predicting that the number of stokes would drop from 88,000 to 40,000 per year.

With these results, it is perhaps surprising that Warfarin is not in wider use. The drug has been around for 50 years, but many doctors are afraid or reluctant to use it. The reason is that the drug's blood thinning properties can also cause bleeding. But research shows that those concerns may be overrated.

"With the large clinical trials, the bleeding problems have turned out to be relatively small, and certainly worth it for the patient," Katz said.

Federal health officials say since the concerns for bleeding are there, the key is to use Warfarin safely. Patients should have regular blood tests and follow-up exams. With today's spiraling cost of healthcare, more efficient use of Warfarin could save 600 million dollars every year, officials said.

Besides Warfarin, government researchers also took a look at a type of neck surgery called carotid endarterectomy. It improves blood flow to the brain and reduces the chance of clotting and strokes. The researchers concluded that the difficult operation should be reserved for people with serious symptoms and badly blocked arteries.

As for Warfarin, the government wants doctors to get a strong dose of the facts: More effort and wider use of the drug could save lives.