Dr. Bunch presented the results May 5th at the 37th Annual Heart Rhythm Society Scientific Sessions.
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Researchers have discovered that patients taking the clot-preventing drug, warfarin, have more dementia risk in case their blood levels of the medication were often very high or very low.
“Patients who use warfarin as part of their anticoagulation treatment for atrial fibrillation should have their anticoagulation levels closely monitored to ensure proper levels”, said Dr. Bunch.
Warfarin has been used to prevent potentially life-threatening blood clots for more than half a century; an estimated 20 million Americans are now taking the drug. The condition is not immediately life-threatening, but it can cause blood clots to form in the heart.
“Finally, in people that are on warfarin in which the levels are erratic or hard to control, switching to newer agents that are more predictable may lower risk”.
According to Bunch, it’s possible that patients with erratic warfarin levels are more prone to “small clots” or “small bleeds” that could affect the brain.
Scientists in Utah have found a common blood thinner used to treat atrial fibrillation may increase the risk of dementia, including Alzheimer’s disease. It’s a delicate balance, the scientists say, because too much of the drug can lead to hemorrhaging and too little increases the risk of blood clots, leading to a stroke or heart attach.
Atrial fibrillation is considered to be quite common type of arrhythmia, which is a problem with the rate or rhythm of the heartbeat.
In the first phase of the study, researchers at the Intermountain Medical Center Heart Institute in Salt Lake City focused on atrial fibrillation patients who had been treated with Warfarin, a popular anticoagulant, for an extended period of time. “Now that we understand the connection, it’s important that patients and doctors, collectively, are more diligent about monitoring for sleep apnea in order to engage in solutions that may prevent the development of atrial fibrillation and, possibly, thromboembolic complications”. Researchers said that regardless of the adequacy of anticoagulation, the atrial fibrilliation patients have witnessed increased rates of dementia.
For their study, the researchers recruited 10,537 patients, aged 18 and older, who had no history of dementia before the study started.
Different patients responds differently to Warfarin, and its actions in the body take time to develop, so finding the right dosage can be a long process. According to the American Heart Association, an estimated 2.7 million Americans are living with AFib. As well, patients who have erratic levels of the drug may be better off on other drugs.
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A study that compared warfarin patients to those on newer anticoagulant drugs could help sort out the medication’s role, Tomaselli said. More studies would be needed to determine how the combination of atrial fibrillation and Warfarin contribute to dementia risk. “If you’re doing well on warfarin, there’s no reason to worry”, he said.
