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Research studies the performance of blood thinners in the elderly

Yan Xu is a third year undergraduate
medical student at Queen's.

By Rosie Hales, Communications Officer
The line between effective and harmful is a thin one when it comes to the choice of blood thinners in seniors, says new research by Yan Xu, a third year undergraduate medical student at Queen’s, Dr. Ana Johnson, a professor in the Department of Public Health Sciences, and Dr. Chris Simpson, Head of the Division of Cardiology in the Department of Medicine.

In Canada, novel oral anticoagulants, also known as new blood thinners, entered the market in 2010 and are recommended as the first line therapy for stroke prevention in patients with a heart rhythm condition known as atrial fibrillation.

For the authors, Mr. Xu, Dr. Simpson, Dr. Johnson, Dr. Anne Holbrook and Dr. Dar Dowlatshahi, the age of those using these drugs is of particular interest because with increasing age comes an increased risk of bleeding.

“Blood thinners are associated with more hospitalizations due to drug reactions in seniors than any other medication class in Canada, one of the reasons being the window between when the drug is therapeutic and when it becomes harmful,” says Mr. Xu.

In their study published in the Canadian Medical Association Journal Open, the researchers found that new medications were most heavily used in patients over the age of 85, in whom the evidence of benefit and harm compared to warfarin, an older agent used for the same purpose, is limited.

After learning which age groups are being most commonly prescribed the drugs, the next step of the study will involve chart review of bleeding cases caused by these agents at four hospitals in Kingston, Ottawa and Hamilton.

Chris Simpson is Head of the Division of
Cardiology in the School of Medicine.
Ana Johson is a professor in the 
Department of Public Health Sciences

Determining the resources that are used to reverse the bleeding in these patients and their outcomes are crucial to the investigators’ goal of generating and disseminating the best evidence for blood thinner treatment.

“It is crucial to understand the resource utilization and outcomes of patients in a real world setting,” says Mr. Xu. “It’s quite a unique collaboration that we have here.

The study was noted in the New England Journal of Medicine’s Journal Watch, a website developed by the prestigious journal to impart information to clinicians worldwide.

The study is available by open access through the publisher's website.