Doctor says stroke risk could be offset with earlier treatment

CHARLESTON, SC (WCSC) - New research is challenging what doctors have learned for decades in medical school, and it could affect those members of the population at risk of stroke.

South Carolina is part of the "stroke belt," which means people in this state have a greater chance of having a stroke. Chances are higher if a person is over 65 years old, has high blood pressure, or has irregular heartbeats, known as  atrial fibrillation. The problem with atrial fibrillation, a person may not always show symptoms.

The latest research, presented before the American Heart Association, found only a few minutes of an irregular heart beat can dramatically increase the risk of stroke.

That's compared to the one to two days medical students are taught to wait before giving treatment.

The current practice calls for a patient to be in abnormal heart rhythm for 24-48 hours before being prescribed a blood thinner. Doctors believe it takes a day or two for the blood to start to clot before there's a risk of stroke.

But the significant finding in the latest research showed short episodes of atrial fibrillation were just as risky.

In the ASSERT study, doctors used patients with pacemakers to monitor silent arrhythmias more accurately and found that only six minutes of an arrhythmia increased the risk of stroke 250 percent.

"So it really changes our perspective," said Dr. Michael Gold, cardiologist at MUSC who oversaw the study in the United States.

The research was conducted in 17 countries across the globe, and followed 2,500 patients who had pacemakers, were elderly, and had high blood pressure.

The findings were surprising.

"It suggests that we may need to start giving blood thinners much earlier and not wait for them to show up in atrial fibrillation and particularly, if they have pacemakers in place, we can diagnose it years earlier,"  said Dr. Gold.

Gold says doctors now need to rethink when patients should be prescribed blood thinners.

"We need to start trying to identify patients early. So right now, we know the markers for stroke are people with high blood pressure, people as they get older in age, with diabetes, with arrhymias like atrial fibrillation.  We don't use blood thinners unless there's documented atrial afibrillation.  But data like this indicates we need to start thinking about being more aggressive," he said.

Dr. Gold says it could reduce one of the biggest causes of stroke.

"That would be a great advance in a place like South Carolina where there is so much stroke."

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