New tool offers a possible breakthrough in prevention
Peter Loewen, a professor in the Faculty of Pharmaceutical Sciences, has developed a calculator to help physicians and pharmacists assess a patient’s risk of stroke and make decisions about the best treatment options to prevent it.
What is atrial fibrillation and how does it increase a person’s risk of stroke?
Atrial fibrillation is a heart rhythm disorder–also known as heart arrhythmia–that develops with age. Your heart is made up of four chambers and the two chambers on top are called the atria. Atrial fibrillation is what happens when these two top chambers don’t beat regularly. The danger is that blood in the atria isn’t moving and can form clots. Sometimes these clots break away and make their way to your brain and this is what causes a stroke.
About 15 per cent of Canadians over the age of 75 will develop atrial fibrillation. My risk calculator helps people make treatment decisions by taking into account other factors for stroke like high blood pressure, diabetes, age, heart failure, having a prior stroke, as well as risk factors for bleeding caused by the treatment options.
What treatment options are available to those living with atrial fibrillation?
Traditionally there was one main option called warfarin, an anticoagulant that helps reduce the risk of clots forming. There was also the option to treat patients with regular aspirin, which is much less effective. In the last few years, three new anticoagulants have become available in Canada. Each has its advantages and disadvantages. It means clinicians have to choose from several options and decisions can be difficult to make.
Anticoagulants effectively reduce the risk of stroke but they also increase the risk of bleeding, which can be anything from a nosebleed or bruising to life-threatening bleeds that happen in the brain or gut. Clinicians wrestle with deciding which therapy to use. The calculator helps with that decision by looking at each individual’s risk factors and determining which treatment works best for that patient. It was recently adopted by the American College of Cardiology as a mobile app.