For patients with atrial fibrillation (AF), the risk of stroke or heart attack from stopping anticoagulants usually outweighs the risk of bleeding, according to new findings from the University of Bath.
Although clinicians often worry about prescribing blood thinners to older patients due to concerns about falls and bleeding, this study suggests the health risks of not taking these drugs are significantly higher.
AF is linked with a fivefold increase in stroke risk and contributes to around 20,000 strokes annually in the UK. Blood thinners are highly effective in managing AF and preventing serious complications.
The new study, published in *Heart*, analyzed data from patients aged 75 and over and found no significant change in the risk of major bleeds after stopping anticoagulants. However, risks of stroke and death tripled during periods off treatment, and the risk of heart attacks nearly doubled.
Cases of AF are rising, especially among those aged 85+, with prevalence in men and women increasing significantly between 2000 and 2016.
This study is believed to be the first to measure outcomes when anticoagulants are stopped in older patients with AF. It underscores the importance of continuing treatment, particularly with modern medications like direct oral anticoagulants (DOACs), which are easier and safer to use than warfarin.
Dr Anneka Mitchell, lead researcher, emphasizes the need for shared, informed decisions between clinicians and patients before stopping anticoagulants. The study shows that stopping therapy may not lower the risk of major bleeding but does increase the likelihood of serious events.
Dr Anita McGrogan noted that older adults were underrepresented in pre-licensing clinical trials for DOACs. The new analysis, based on anonymous GP data from over 20,000 people aged 75+, fills a crucial evidence gap.
Dr Tomas Welsh adds that while new-generation blood thinners aren’t always suitable for frail patients, this research equips clinicians with better information to evaluate risks and benefits with patients.
If you care about stroke, please read research about Research finds a better high blood pressure treatment for stroke patients and findings of Scientists find a better drug than statins for stroke patients.
For more information about stroke, please read studies about Half of people with heart rhythm diseases dying of heart attack, stroke and findings of New method reduces heart attacks and strokes over five years.
The study is published in Heart.
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