Re: questions on atrial fibrillation

On Tue, 22 Nov 2005 11:42:06 -0500, "Andrew B. Chung, MD/PhD"
<andrew@xxxxxxxxxxxxxx> wrote:

>Uplbet wrote:
>>
>> I heardsay about "maneuvres" that can be tried on intermittent
>> afibbers to get them converted back into sinus rhythm.
>> Is that correct?
>
>No.
>
>> And if so, where can I read about that?
>>
>> One more question: as far as the anti-thrombotic / anti-stroke effect
>> is concerned, what is the difference between Ticlopidine and Warfarin
>> therapies for afibbers?
>
>The latter works while the former does not.
>
>> In other words, can Ticlopidine also be considered, at least to a
>> certain extent, as a "blood thinner" like Warfarin?
>
>No.
>

Andrew, that is not entirely correct. Ticlopidine has never been
studied as an antithrombotic to prevent strokes in a fib. Clopidogrel,
the other member of the ticlid-type medicine class (the
thienopyridines) was recently studied in afib with aspirin compared to
warfarin. This study, "ACTIVE-W," was stopped early due to
inferiority of the asa-clopidogrel arm vs. warfarin.

However, this certainly does not mean that clopidogrel (and by analogy
ticlopidine) does not have any efficacy in afib, it just means its not
as good as warfarin. Aspirin alone clearly cuts the risk of stroke in
AF vs. no therapy, and the ongoing ACTIVE-A trial is comparing the
combination of aspirin and clopidogrel vs. aspirin in patients
inolerent of warfarin.

In summary, ticlid likely has some beneficial effect in preventing
strokes in AF. It is clearly inferior to warfarin, but is likely
better than no therapy, and in combination with aspirin may be better
than aspirin alone (we'll have to wait for the ACTIVE-A results).

MEM
.

Relevant Pages

  • Re: questions on atrial fibrillation
    ... >> Andrew, ... >> thienopyridines) was recently studied in afib with aspirin compared to ... >> inferiority of the asa-clopidogrel arm vs. warfarin. ... >> ticlopidine) does not have any efficacy in afib, ...
    (sci.med.cardiology)
  • Re: questions on atrial fibrillation
    ... >>> afibbers to get them converted back into sinus rhythm. ... what is the difference between Ticlopidine and Warfarin ... > thienopyridines) was recently studied in afib with aspirin compared to ...
    (sci.med.cardiology)
  • Re: questions on atrial fibrillation
    ... > afibbers to get them converted back into sinus rhythm. ... what is the difference between Ticlopidine and Warfarin ...
    (sci.med.cardiology)
  • questions on atrial fibrillation
    ... afibbers to get them converted back into sinus rhythm. ... what is the difference between Ticlopidine and Warfarin ...
    (sci.med.cardiology)
  • Re: questions on atrial fibrillation
    ... >>after four years on warfarin, a year ago my electrophysiologist let me ... >>switch to aspirin when he realized ... of anti-coagulation to use during the 8 years I had paroxysmal AFib. ... But, anyway, I'm not worried anymore as I no longer have AFib anymore ...
    (sci.med.cardiology)