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MONDAY, Jan. 8 (HealthDay News) -- The rate of bleeding in the brain associated with use of the anticoagulant drug warfarin quintupled during the 1990s, University of Cincinnati researchers reported Monday.
Moreover, in people over 80, the rate of brain hemorrhages associated with warfarin, best known as Coumadin and used to thin the blood and prevent strokes, increased more than tenfold, according to the study, published in the Jan. 9 issue of Neurology.
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"Warfarin use increased during the 1990s, because it was proven to be effective in preventing ischemic strokes among people who have an abnormal heart rhythm called atrial fibrillation," said the study's lead author, Dr. Matthew L. Flaherty, a neurologist.
The drug is commonly prescribed to prevent blood clotting, which can lead to ischemic stroke, the most common type of stroke. However, warfarin is associated with another type of stroke, called an intracerebral brain hemorrhage, which is a ruptured blood vessel resulting in bleeding in the brain, Flaherty explained.
In the study, Flaherty's team collected data on all patients in the greater Cincinnati area hospitalized with a first-time intracerebral hemorrhage during 1988, 1993-94, and 1999.
The researchers found that in 1988, the annual rate of intracerebral hemorrhages associated with warfarin was 0.8 cases per 100,000 people, and, in 1999, the rate was 4.4 cases per 100,000 people. Among those 80 and older, the rate increased from 2.5 in 1988 to 45.9 in 1999, they report.
Flaherty thinks that doctors need to be cautious in prescribing warfarin, especially to patients over 80. "Some of those patients are better off being on warfarin," he said. "The message isn't that no one should use warfarin. There needs to be a balance between the benefit of preventing ischemic stroke and the risk of bleeding."
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