BusinessDay
NigeriaDecides2023

How anticoagulants play key role in preventing stroke on irregular heart beats

Some eighteen million people die yearly around the world from cardiovascular diseases such as heart attack data compiled by the World Health Organisation (WHO) show. According to the WHO’s data published in 2020 Coronary Heart Disease Deaths in Nigeria reached 61,374 or 4.14% of total deaths. See the total deaths and age adjusted death rate for Coronary Heart Disease Nigeria.

In Nigeria and most of the world this is still more male-dominated than female with a ratio of about 60 – 40 percent. Women start to catch up with men after menopause adding that about 70-80 percent of heart diseases are preventable.

Stroke is a leading cause of disability, dementia and death worldwide. Approximately 70% of deaths from stroke and 87% of stroke-related disability occur in low-income and middle-income countries.

People with certain heart or blood vessel disease conditions, abnormal heartbeat, heart valve replacement, congenital heart defects, and blood clots after surgery will need anticoagulants. An abnormal heartbeat is associated with considerable morbidity, including an increased risk of cognitive impairment, a three-fold increase in the risk of heart failure, and a five-fold increase in the risk of stroke.

However, anticoagulants reduce the risks of stroke and prevent heart attacks. Anticoagulants (also popularly called “blood-thinners”) are medications that help prevent blood clots. This is prescribed for people at a high risk of getting clots, to reduce their chances of developing serious conditions such as strokes and heart attacks.

A blood clot is a seal created by the blood to stop bleeding from wounds. While they are useful in stopping bleeding, they can block tiny blood vessels and stop blood flowing to organs such as the brain, heart or lungs if they form in the wrong place.

In an interview with a national daily in 2021, Kingsley Kola Akinroye, executive secretary of, Nigerian Heart Foundation (NHF) said that the gradual increase in the prevalence of heart disease in Nigeria is a major concern, as it is the commonest cause of death in adult population. Akinroye said hypertension is the number one heart disease affecting not less than 10 million adults in Nigeria and only about one-third are on effective treatment.

As the number of diagnoses continues to rise, there is no effective treatment yet. New treatment strategies are urgently needed to improve the treatment success rate of severe and critically ill patients.

Read also: 5 charts showing FG’s basic healthcare fund allocation in 2022

Increasing evidence has shown that anticoagulants or blood thinner medicines play an important role in the progression of preventing blood clots from forming.

In 2007, Pfizer and Bristol Myers Squibb entered into a worldwide collaboration to develop and commercialise apixaban, an oral anticoagulant discovered by Bristol-Myers Squibb.

While warfarin is commonly prescribed to prevent blood clots. However, newer types of anticoagulants are available and are becoming increasingly common. Among these is apixaban (Eliquis).

Eliquis contains the active substance apixaban. It can be taken with or without food. The tablets should be swallowed with a drink of water. The tablet may also be crushed and mixed with water, or 5% glucose in water, or apple juice, immediately before the drug is taken.

It is important to treat blood clots because clots in your blood vessels and heart can cause heart attacks, strokes, and blockages. Study shows that one of the risk factors that can lead to stroke is when the blood clots break off and travel to the brain or to other organs and prevent normal blood flow to that organ. This is known as a systemic embolism. A stroke can be life-threatening and requires immediate medical attention.

“Non-Valvular Atrial Fibrillation (NVAF) increases the risk of stroke by approximately 5-fold compared to the risk of stroke in patients without NVAF. It is also associated with increased severity, disability, and an increased risk of death,” said Dike Ojji, consultant cardiologist, Department of Internal Medicine, College of Health Sciences, University of Abuja & University of Abuja Teaching Hospital, Gwagwalada, Abuja.

NVAF in patients has a 30-day mortality rate of 33% (vs. 16% for non-AF strokes) 2 and 1-year mortality rates of ~50% (vs. 27% for patients without AF).

According to the cardiologist, 20 percent of all strokes in the general population are due to Atrial Fibrillation adding that apixaban demonstrated superior efficacy versus ASA without significantly increasing the risk of major bleeding.

The expert says apixaban demonstrates a superior stroke and systemic embolism prevention by 21%, superior profile in reducing major bleeding by 31%, and superior reduction in all-cause mortality by 11% versus warfarin.

Eliquis should be taken as recommended for the following: to prevent a blood clot from forming in the heart in patients with an irregular heartbeat and at least one additional risk factor.

Your doctor or nurse should tell you how much of your anticoagulant medicine to take and when to take it. Most people need to take their tablets twice a day with water.

The length of time you need to keep taking your medicine for depends on why it’s been prescribed.

For preventing blood clots from re-occurring following completion of 6 months of treatment the recommended dose is one tablet of Eliquis 2.5 mg twice a day for example, one in the morning and one in the evening.