New blood thinners from Boehringer Ingelheim GmbH and Bayer AG should be used to prevent stroke in patients with a common irregular heartbeat known as atrial fibrillation, the European Society of Cardiology recommended.
The drugs “offer efficacy, safety and convenience” compared with standard therapy and should be considered for most patients with atrial fibrillation when anticoagulants are recommended, authors of the guidelines, led by John Camm of St. George’s University of London, said in a statement today at the group’s annual conference in Munich.
Therapies approved since 2010, when the last guidelines were published, include Boehringer’s Pradaxa and Xarelto from Bayer and Johnson & Johnson. There’s insufficient evidence to recommend one drug over the other, according to the statement. The standard treatment has been warfarin, a drug approved in 1954. Patients on warfarin have to undergo periodic monitoring with blood tests.
Atrial fibrillation affects almost 2 percent of the population, with the average age of patients between 75 and 85 years old, according to the guidelines. The condition is associated with a fivefold increased risk of stroke and threefold higher risk of heart failure, the authors said.
Evidence that favors aspirin in stroke prevention is weak, they said. Aspirin carries a high risk of bleeding in elderly atrial fibrillation patients, and should be given only to those who refuse to take an anticoagulant, they said.
“Taken together these changes should lead to a major improvement of the care of patients with atrial fibrillation, the most prevalent sustained cardiac rhythm disturbance,” according to the statement.
Pfizer Inc. and Bristol-Myers Squibb Co. are seeking approval of a drug called Eliquis to treat atrial fibrillation. If approved, the drug should be considered along with Pradaxa and Xarelto, according to the guidelines.
Other guidelines announced today recommend that patients suspected of having a severe heart attack receive the drug clopidogrel, also known as Plavix, made by Bristol-Myers Squibb and Sanofi, and aspirin within 30 minutes of the start of medical treatment and angioplasty within 90 minutes.
The European Society of Cardiology represents more than 75,000 doctors who treat cardiovascular disease.