A study conducted by US-based Duke Clinical Research Institute researchers has revealed that warfarin, a drug prescribed to prevent strokes in patients with atrial fibrillation, may not be able to adequately control long-term blood clotting.

The revelation is based on research conducted over 18 months on 3,749 patients diagnosed with atrial fibrillation, an irregular heart rhythm that causes rapid and irregular beating.

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This abnormal heart rhythm might involve greater risks of blood clots and stroke that can be avoided with the use of drugs that can thin the blood and prevent clots, known as anticoagulants.

Warfarin is the only drug available for stroke prevention and is an anticoagulant that uses its anti-clotting mechanism to target the use of vitamin K by the human body.

"Warfarin is the only drug available for stroke prevention and is an anticoagulant that uses its anti-clotting mechanism to target the use of vitamin K by the human body."

However, the stroke-preventing treatment can interact negatively with a wide range of other drugs and food. Patients treated with warfarin need to be monitored regularly.

Drugs that were first approved in the US in 2010, known as non-vitamin K oral anticoagulants (NOACs), largely eliminate the drawbacks related to the use of warfarin.

Though more costly than warfarin, NOACs can often provide similar effectiveness but with improved safety.

Duke University School of Medicine electrophysiology fellow and the study first author Dr Sean Pokorney said: “For these reasons, the majority of patients who are newly diagnosed with atrial fibrillation are prescribed NOACs.

“One of the challenges we face as a health-care community is that there are patients who have been on warfarin for years, and a big question is whether they should be switched to a NOAC.”

According to Pokorney, the study reveals that patients’ past performance on warfarin cannot determine their future performance and they may not continue to do well under the treatment.

Funding for the patient registry and data analysis has been provided by US-based Janssen Scientific Affairs.