A new anti-clotting drug may help protect patients with non-valvular atrial fibrillation (AF) and moderate to high risk of stroke against clot-related strokes and minimize the risk of causing a bleeding stroke, according to an American Heart Association press release. The findings were reportedly presented at the American Stroke Association’s International Stroke Conference 2012.

The press release reports that the findings originated from a sub-analysis of data in a large, randomized clinical trial called ROCKET AF. The trial was reportedly conducted in 45 countries at 1,178 sites. During the ROCKET AF trial, researchers say patients with AF were treated with a new drug, rivaroxaban, which assists in thinning the blood and preventing ischemic strokes, against warfarin. The results suggested that in AF patients without any history of heart valve damage, 34% were less likely to experience an intracranial hemorrhage, compared to AF patients treated with warfarin.

Graeme J. Hankey, MMBS, MD, FRCP, FRCPE, FRACP, neurologist at the Royal Perth Hospital, Perth, Western Australia, and University of Western Australia, also located in Perth, led the study. Hankey recommends cautious enthusiasm in regard to the study’s findings, “Anticoagulant drugs can prevent ischemic strokes, but paradoxically, they can cause intracranial bleeding, including hemorrhagic strokes,” Hankey says.

The study also indicates potential risk factors that were independent of the treatment and elevated the probability of intracranial bleeding in AF patients. The first factor in older adults, the study reports, risk increased by 1/3 for every 10 years of age. Prior stroke or transient ischemic attack (TIA) also boosted the risk of intracranial bleeding by 51%, researchers say. The results also suggested that African American AF patients exhibited a 4.2-fold increase in risk compared to Caucasian patients and Asian patients exhibited a two-fold increased risk of intracranial bleeding. Lastly, researchers note that low platelet count also heightened the risk of intracranial bleeding.

Researchers say the ROCKET AF’S primary findings, presented at the American Heart Association’s Scientific Sessions 2010, indicate the drugs rivaroxaban and warfarin exhibit equal protection against stroke or systemic blood clots in AF patients. The findings also conclude that rivaroxaban patients experienced less intracranial bleeding and fatal bleeding than their warfarin-treated counterparts. 

Researchers add that a follow-up of 2 years indicated that 136 of the 14,264 study participants had experienced an intracranial bleed. The overall rate translated to .5% per year, Hankey points out.

Source: American Heart Association