Heart Beat September 2015 Issue

Heart Beat: September 2015

Bleeding antidote may be on the way for warfarin alternative

One of the concerns about some of the newer drugs designed to be alternatives to warfarin (CoumadinŽ) is that they lack an antidote to excessive bleeding. Dabigatran (PradaxaŽ) has been hailed as a safe and effective alternative to warfarin, which can be difficult to dose correctly in many patients. And now a new drug called idarucizumab may provide the bleeding antidote that could make dabigatran an even safer drug for patients. A recent study published in the New England Journal of Medicine found that idarucizumab reversed bleeding events caused by dabigratran within minutes. More testing and approval by the U.S. Food and Drug Administration still awaits. But the results of this trial are encouraging. Dabigatran works consistently without the kind of frequent dosing adjustments often required of patients on warfarin. These anticoagulant medications are taken to help prevent blood clot formation. But because they act as “blood thinners,” they raise the risk of bleeding episodes. Warfarin has an antidote, which gives physicians and patients some peace of mind. Though unusual, serious bleeding events caused by anticoagulants can be life threatening. Researchers are hoping that if the dabigatran antidote continues to meet expectations in studies, it will make doctors less reluctant to prescribe dabigatran in the future.

Survey reveals americans’ poor understanding of heart failure

An estimated six million Americans live with heart failure, but a recent survey suggests that more than half the population doesn’t really know what heart failure is, and nearly half think that it has no symptoms. The American Heart Association surveyed more than 1,600 people in the organization’s first review of heart failure knowledge in the U.S. Among the results was that 58 percent of those surveyed believed heart failure is a natural cause of death that occurs when the heart just stops beating. About 46 percent thought heart failure is a “silent killer” that has no symptoms. Other survey answers suggest that many Americans have the details of heart attack and heart failure confused. Heart failure is a condition that usually develops over time, and is defined as a weakening of the heart’s ability to pump blood throughout the body. There are several potential causes for heart failure, and there are many symptoms. Common signs of heart failure include edema (swelling in the feet and lower legs), fatigue, lightheadedness, coughing while lying down, reduced ability to exercise, difficulty making decisions, shortness of breath and, if the heart failure is caused by a heart attack, persistent chest pain. If you have had a heart attack or have had valvular heart disease or chronic high blood pressure, talk with your doctor about your risk for heart failure. And remember that heart failure can be treated in many cases with a combination of a heart-healthy lifestyle, medications and, in more serious cases, cardiac devices and artificial pumps.


Folic acid supplementation may help reduce stroke risk

Individuals with high blood pressure face elevated stroke risk. Nearly 800,000 people in the U.S. have a stroke every year, and the vast majority of them are first-time strokes. A recent study published in JAMA suggests that the combination of folic acid supplementation and antihypertensive medications may be an effective way to reduce first-time stroke risk. Folic acid is a B vitamin that the body needs for healthy cell production. A lack of folic acid can result in anemia and other health problems. Women are often advised to keep their folic acid intake up prior to and during pregnancy to help avoid birth defects. Folic acid has been studied previously as a possible preventive tool against heart disease. But this study specifically looked at whether adding folic acid to a regimen that included blood pressure-lowering medications could help prevent first-time strokes. Results of the study showed slight protective benefits from folic acid supplementation. But that doesn’t necessarily mean you should immediately start taking folic acid supplements. Folate is the type of folic acid found naturally in certain foods. Folic acid is the synthesized version of the B vitamin. Good sources of folate include dark green, leafy vegetables, as well as fruits, nuts, beans and peas. If you’re concerned about your folate intake, try to increase your consumption of these foods and talk with your doctor or a dietitian about whether you need to supplement your diet.

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