Important work published in JAMA Neurology today, explores the residual risk of recurrent stroke in patients with atrial fibrillation (AF) and suggests that current treatment strategies are insufficient and that new treatments to prevent stroke in high-risk patients are urgently required.
Atrial fibrillation (AF) causes approximately 1 in 3 strokes and the global prevalence of AF is rising dramatically due to population ageing. Although treatment with oral anticoagulants (blood thinners) reduces the risk of stroke, it is uncertain how effective these treatments are in the long-term in patients who have already suffered a stroke, as these patients probably are at a higher risk.
In this international collaborative project, led by Dr John McCabe and Professor Peter Kelly from UCD School of Medicine, data from 23 studies and 78,000 patients with previous stroke were analysed. The risk of recurrent stroke was 5% per year overall, with an estimated 1 in 6 patients anticipated to have another stroke over 5 years.
The residual recurrence risk after AF-related stroke remains unacceptably high despite modern secondary prevention, emphasising the urgent need for new therapeutic strategies and new clinical trials of new therapies in this patient group.
Dr McCabe states that, ‘‘These results strongly suggest that current treatment strategies are insufficient and that new treatments to prevent stroke in high-risk patients are urgently required."
The paper is titled ‘Residual Risk of Recurrent Stroke Despite Anticoagulation in Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis’ and can be accessed here.