Over two thirds of physicians point out preventing ischaemic stroke as the most important treatment goal for patients with atrial fibrillation (AF)1
Physicians highlight the vital need for awareness of the true incidence of ischaemic stroke1
92% of all strokes in patients with AF are ischaemic strokes2, making ischaemic stroke prevention a key treatment priority
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New findings from a pan-European online survey of 1,000 physicians have demonstrated that for over two thirds of physicians, preventing ischaemic stroke is the most important treatment goal for patients with atrial fibrillation (AF).1 Ischaemic stroke is the most common type of stroke suffered by patients with AF2, and as such physicians across Europe have highlighted the vital need for increased awareness of the true incidence and impact in this patient population. The survey findings were announced in parallel with the European Stroke Conference in London (28th-31st May) and highlight the need for additional information and education about the risk and impact of ischaemic stroke on the lives of AF patients.
Every year, up to three million patients with AF have a stroke.3,4 92% of strokes in AF patients are ischaemic.2 They occur when a blood vessel supplying the brain with blood is blocked e.g. by a blood clot. This reduction or complete prevention of blood flow to the brain may result in severe and burdensome physical impairment, paralysis or even death.5 Atrial fibrillation is the most common sustained heart rhythm condition6 affecting approximately 2% of the total population.7 The condition leads to a five-fold increase in the risk of stroke.7
“Every physician who treats patients with atrial fibrillation needs to recognise the risk of ischaemic stroke in these patients,” commented Professor Hans-Christoph Diener, Professor of Neurology and Chairman of the Department of Neurology, University of Essen, Germany. “Today, we have great and new possibilities at hand to prevent many of these devastating events. It is our responsibility as treating physicians to identify the patients in need for stroke prevention through screening, diagnosis and risk assessment and then protect them as best as we can from the possible consequences of an ischaemic stroke or an intracranial haemorrhage.”
Cardiologists and general practitioners (GPs) in seven European countries were surveyed via a MedLIVE™ PULSE online survey to ascertain their perspectives on treatment priorities in AF. The survey explored factors affecting prescribing behaviours, such as the importance of stroke prevention in AF, the comparative need for treatment experience and convenience, and the perceived awareness of the incidence of ischaemic stroke. Key findings demonstrated:1
67% of physicians state that preventing ischaemic stroke is the most important treatment goal for patients with AF
84% of physicians highlight the vital need for awareness of the impact of ischaemic strokes for patients with AF, stating that the true incidence may be underestimatedi
When questioned on important factors that affect prescribing decisions, 56% of physicians responded that protecting patients against ischaemic stroke is the single most important factor affecting their prescribing decisions, followed by general treatment efficacy (protection against all strokes) and treatment safety (minimising the risk of bleeding in patients)
When asked which attributes were most important when choosing treatments for patients with AF, 50% of physicians stated that the availability of clinical data was the most important attribute to consider and 39% selected experience in clinical practice over the treatment’s convenience for daily management
“Ischaemic stroke is a real concern; not only because the risk is so high, but also because of the potential life-changing impact that it may have on patients with atrial fibrillation. Ischaemic strokes can be devastating for both patients and their families, and have a significant impact on their daily lives. They also increase healthcare utilisation and the need for long-term care,” stated Trudie Lobban, MBE, Founder & CEO of Atrial Fibrillation Association (AFA). “It is essential that more work is undertaken to raise awareness of the risk of ischaemic stroke and to ensure that patients with AF receive treatments that provide the most comprehensive protection.”
Appropriate anticoagulation therapy can help to prevent strokes experienced by patients with AF and improve overall outcomes.8 Major treatment guidelines in Europe, the US and worldwide recognise the benefits of anticoagulant treatments for stroke prevention in atrial fibrillation.9 Pradaxa® (dabigatran etexilate) 150mg bid is the only novel oral anticoagulant, for which its trial (RE-LY®ii, comparing Pradaxa® vs. warfarin) has shown a relevant reduction of ischaemic stroke: In patients with non-valvular AF, Pradaxa® 150mg reduced the risk for ischaemic stroke by 25% compared to warfarin.10,11 In addition, patients taking Pradaxa® 150mg had a 59% lower risk of intracranial bleeding, the most feared side-effect of anticoagulation.10,11
Overall in the RE-LY® trial, Pradaxa® 150mg bid provided a 35% reduction in the overall risk of stroke and systemic embolism versus warfarin.10,11 Pradaxa® 110mg bid was shown to be non-inferior compared to warfarin for the prevention of stroke and systemic embolism.10,11 Pradaxa® 150mg showed a similar risk of major bleeds versus warfarin and Pradaxa® 110mg bid demonstrated significantly lower major bleeding.10,11 Both doses of Pradaxa® were associated with significantly lower total, intracranial and life-threatening bleeding compared to warfarin.10,11
Clinical experience of Pradaxa® exceeds that of all other novel oral anticoagulants: It equates to over 1.6 million patient-years in all licensed indications and spans over 100 countries worldwide.12
~ENDS~
i The survey did not ask the polled physicians for potential reasons why the true incidence of ischaemic stroke may be underestimated. Potential influencing factors may include the challenge of detecting silent events and/or cryptogenic strokes without routine implementation of screening tests.
ii RE-LY® was a PROBE trial (prospective, randomized, open-label with blinded endpoint evaluation), comparing two fixed doses of the oral direct thrombin inhibitor dabigatran etexilate (110 mg bid and 150 mg bid) each administered in a blinded manner, with open label warfarin.10,11
Please click on the link below for ‘Notes to Editors’ and ‘References’:
http://www.boehringer-ingelheim.com/news/news_releases/press_releases/2013/28_may_2013_dabigatranetexilate.html
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