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Adequate anticoagulation reduces impact of stroke for patients with atrial fibrillation

A research team from Massachusetts General Hospital (MGH) and Kaiser Permanente of Northern California has shown that patients with atrial fibrillation who receive an appropriate level of anticoagulation therapy not only reduce their risk of having a stroke, they also cut the risk that any stroke they have will result in death or serious disability. The study appearing in the September 11, 2003, New England Journal of Medicine is the first to examine the effect of anticoagulation intensity on stroke outcome in patients with atrial fibrillation.

"It is very unusual to have a stroke when on anticoagulation therapy, but this study shows that it is possible to reduce the severity and complications for patients who do experience that uncommon event," says Elaine Hylek, MD, of the MGH General Medicine Division, the study's lead author.

Atrial fibrillation, a type of irregular heartbeat, is the strongest common risk factor for stroke. By leading to the formation of blood clots that travel to the brain, the condition is believed to account for about 80,000 strokes a year and can increase a patient's overall stroke risk fivefold. Many patients with atrial fibrillation are treated with blood-thinning medications most frequently aspirin or the prescription drug warfarin and previous studies by members of this research team and others have confirmed that achieving adequate levels of anticoagulation as reflected by levels of 2.0 to 3.0 on a blood test called INR can significantly reduce the risk that a stroke will occur.

The current report is part of a larger effort called the AnTicoagulation and Risk Factors In Atrial Fibrillation (ATRIA) study, a collaboration between researchers at MGH and Kaiser Permanente of Northern California. The investigators collected and analyzed data on more than 13,000 Kaiser patients with atrial fibrillation, and the NEJM study reflects information from almost 600 patients who experienced ischemic (caused by a
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Contact: Sue McGreevey
smcgreevey@partners.org
617-724-2764
Massachusetts General Hospital
10-Sep-2003


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