Preventing Stroke: Is There a Better Drug Than Coumadin for Atrial Fibrillation Patients?

ST. LOUIS – Is there a safer, more effective alternative to the commonly used blood thinner Coumadin in preventing stroke in patients with atrial fibrillation? Saint Louis University researchers are set to find out in a new study.

Saint Louis University is the only site in the metropolitan area to participate in the international study, which hopes to enroll 15,000 patients at 400 locations.

Four million Americans have atrial fibrillation, a condition that occurs when the upper and lower chambers of the heart begin beating at mismatched rhythms. Because the rapidly contracting atrium cannot empty properly, blood pools in the atrium and a clot may form. If these clots break free, they can lodge in an artery of the brain and cut off the blood supply to that area, causing a stroke.

People with atrial fibrillation are nearly five times as likely to suffer stroke as those without.

For more than half a century, Coumadin, also known as warfarin, has been the anticoagulant of choice for doctors in preventing stroke in atrial fibrillation patients. Study researchers will compare the efficacy and safety of an experimental drug called dabigatran etexilate versus Coumadin in preventing stroke.

“We hope this drug will be at least as effective in preventing stroke in atrial fibrillation patients,” says Arthur J. Labovitz, M.D., director of the division of cardiology at Saint Louis University School of Medicine. “We’re also hoping it might cause less bleeding and have fewer negative side effects than Coumadin.”

Coumadin has the potential to interact negatively with other drugs such as antibiotics, Labovitz says. Additionally, patients on Coumadin must restrict their consumption of vitamin K-rich foods such as spinach and broccoli because vitamin K acts as a bloodclotter.

Saint Louis University’s Echo Core Lab has also been asked to serve as the coordinating center for the study. Researchers and technicians here will evaluate the echocardiograms performed for the study at the 400 different sites globally. The Saint Louis University Echo Core Lab is directed by Labovitz and serves as the coordinating center for many NIH- and industry funded atrial fibrillation studies.

Of the 15,000 patients, two-thirds will receive either 110 mg or 150 mg of dabigatran, while the remaining one-third will take Coumadin.

Volunteers are needed to enroll in the study. Volunteers must be diagnosed with atrial fibrillation. Other inclusions and exclusions may apply. For more information or to enroll in the study, call Lisa Bilbrey at (314) 577-8876, ext 3.

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first M.D. degree west of the Mississippi River. Saint Louis University School of Medicine is a pioneer in geriatric medicine, organ transplantation, chronic disease prevention, cardiovascular disease, neurosciences and vaccine research, among others. The School of Medicine trains physicians and biomedical scientists, conducts medical research, and provides health services on a local, national and international level.

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