2 blood thinners help with irregular heartbeat during surgery in trial

By Allen Cone  |  Updated March 20, 2018 at 12:18 PM
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March 20 (UPI) -- A clinical trial in the United States and Europe determined that two blood thinning drugs help patients with an irregular heartbeat during surgery, and also improved cognitive function.

In the trial, led by the University of Birmingham, researchers examined the effectiveness of the anticoagulant drugs, called Apixaban and Vitamin K antagonists. The findings were published Tuesday in the European Heart Journal and presented at the European Society of Cardiology's Congress in Barcelona, Spain.

"The results of this trial will go a long way towards reassuring clinicians that continuous Apixaban is a safe and effective alternative to VKA for patients undergoing atrial fibrillation ablation, even those at risk of stroke," Dr. Paulus Kirchhof, a researcher at the University of Birmingham's Institute of Cardiovascular Sciences and lead trial investigator, said in a press release.

Atrial fibrillation is a condition that causes an irregular heartbeat. Someone with atrial fibrillation has more than five times the risk of stroke and the condition triggers one in five strokes, according to the American Heart Association.

The conditioned can be treated by stopping the irregular electrical signals in the heart through catheter ablation.

"Catheter ablation is being used increasingly to treat patients with symptomatic atrial fibrillation, but the procedure leaves patients at a certain risk of stroke, bleeding, and clinically silent acute brain lesions," Kirchhof said. "We also know that thrombotic events can impair cognitive function.

The German Atrial Fibrillation NETwork, in cooperation with the German Center for Cardiovascular Research, compared Apixban and VKAs in a random trial of 633 patients in nine countries in Europe and the United States before and after their catheter ablation.

"We found the bleeding rate was half of what we have expected and there was a remarkably low rate of stroke, with only two events being observed in the trial," Kirchhof said. "In addition, seven episodes of cardiac tamponade -- two with Apixaban and five with a VKA -- were managed with drainage, without the need for antidotes."

The researchers also used the Montreal Cognitive Assessment test and found a small but statistically significant improvement in cognitive function in both study groups at the end of the study.

Additionally, researchers tested brain magnetic resonance imaging in more than half of the study patients within 48 hours. The results demonstrated no difference in clinically silent acute brain lesions between the treatment methods.

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