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International Stroke Conference 2012: Anticlotting agents offer similar prevention rates of stroke, death in heart failure patients with normal heart rhythm
Warfarin is similar to aspirin in preventing deaths and strokes in patients with heart failure and normal heart rhythm, according to the largest and longest head-to-head comparison study of the 2 anticlotting drugs.
Warfarin is similar to aspirin in preventing deaths and strokes in patients with heart failure and normal heart rhythm, according to the largest and longest head-to-head comparison study of the 2 anticlotting drugs. The results of the late-breaking research were presented at the International Stroke Conference 2012 in New Orleans.
"Although there was a warfarin benefit for patients treated for 4 or more years, overall warfarin and aspirin were similar," said Shunichi Homma, MD, lead author of the study and the Margaret Milliken Hatch professor of medicine at Columbia University, NY.
"Given that there is no overall difference between the 2 treatments and that possible benefit of warfarin does not start until after 4 years of treatment, there is no compelling reason to use warfarin, especially considering the bleeding risk," Dr Homma added.
Researchers randomly assigned patients to receive either 325 mg/day of aspirin or warfarin doses, calibrated to a pre-specified level of blood thinning. They found that death, ischemic stroke, or intracerebral hemorrhage, occurred at a rate of 7.47% for the warfarin patients and 7.93% for patients assigned to aspirin, which is not a "statically significant" difference, the researchers wrote.
However, in the group of patients followed for more than 3 years, those on warfarin did better, according to Dr Homma. Over the entire study period, patients receiving warfarin were just over half as likely to develop a stroke as those taking aspirin.
Conversely, major bleeds occurred in 1.8% of warfarin patients versus 0.9% of aspirin patients, during each year of the study, according to the researchers. "As expected, the overall bleeding rate was higher with warfarin. However, not all bleeds are equal, and the one that patients fear the most-bleeding within the brain [intracerebral hemorrhage]-occurred rarely in both groups," Dr Homma said. Intracerebral hemorrhage occurred in .12% per year in the warfarin patient group and .05% per year in the aspirin group.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
