For patients with atrial fibrillation, the risk of stroke or heart attack from stopping anticoagulants usually outweighs the risk of bleeding, according to new findings from the University of Bath.
AF is associated with a fivefold increase in the risk of stroke, with estimates suggesting it contributes to 20,000 strokes a year in the UK. It also increases the risk of heart attacks and death. Anticoagulants are highly effective in managing AF and preventing strokes and other complications.
However, the new study, published in Heart found that contrary to popular medical belief, stopping anticoagulants for patients aged 75 and over does not change the risk of major bleeds. These findings are important for clinicians to factor into their prescribing behaviour, according to the study’s authors.
‘Prescribers need to consider the increased risk to patients of coming off anticoagulants, including stroke,’ said study author Dr Anneka Mitchell.
Based on data from the UK Clinical Practice Research Datalink, the study found that the risks of stroke and death were three times higher during periods when patients were not receiving anticoagulation therapy. The risk of heart attacks was nearly double compared with periods when patients were treated with anticoagulants.
Mitchell A, et al. Heart 17 February 2025. doi: 10.1136/heartjnl-2024-324763
