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Warfarin Study at the Trust
Written by Communications Team   

Ashford and St. Peter's Hospitals NHS Trust and world-wide Warfarin alternative study

The Cardiac Research team at Ashford and St. Peter's Hospitals NHS Trust has contributed to a two-year study involving 951 clinical centres in 44 countries that could lead to the use of a new drug as an alternative to Warfarin for some patients with atrial fibrillation or flutter.

The Trust’s Lead Clinician for Cardiology Dr Peter Wilkinson was the Principal local Investigator for this clinical trial, carried out by the Trust’s cardiac research co-ordinator Dr Martha Wrigley and cardiac research Sister Caroline Hamper.

Said Consultant Cardiologist Dr Wilkinson: “We anticipate that in the future the new drug may replace Warfarin for some people who have Atrial Fibrillation or flutter. We were delighted to be involved in such an influential study. Previous studies looking for a safe and effective alternative to Warfarin for patients with Atrial Fibrillation have not been so encouraging.”

Patients who have been experiencing an irregular heart rhythm in the form of Atrial Fibrillation are usually placed on Warfarin or aspirin. They may not have been aware of their problem until their condition is picked up by their GP or another health professional. Others experience palpitations or may feel breathless. 
 

 
 
Consultant Cardiologist and the Ashford and St. Peter's Hospitals NHS Trust’s Lead Clinician for Cardiology Dr Peter Wilkinson is pictured here with (left to right) Trust colleagues Dr Martha Wrigley and cardiac research Sister Caroline Hamper. They are pictured at St. Peter’s Hospital with an Echo Machine. This is a diagnostic tool used to look at the functional efficiency of the heart, and to see if there are any blood clots in the chambers.
 
 
When people have Atrial Fibrillation the heart’s rhythm is irregular and blood can “pool” in a chamber, which in turn can form a clot that can cause a stroke in a very small number. To reduce this risk patients are put on blood-thinning drugs such as Warfarin or aspirin. Although Warfarin reduces the risk of stroke in 64% of such patients it can be difficult to achieve a safe, therapeutic level because a patient’s diet can affect the drug’s efficiency as can certain other medication. Therefore, regular monitoring is very important.

Dr Wrigley, who is also the senior lead research nurse for Surrey & Sussex Comprehensive Local Research Network said: “The drug used for this study was Dabigatran. There are some patients who would have little to gain from switching to it from Warfarin. However, for those patients who have Atrial Fibrillation, plus one additional risk factor for stroke, there are benefits. The results of the study found that it prevented more strokes and produced less bleeding than Warfarin in those categories of patients. The drug, taken orally twice daily, also has the advantage of not needing monitoring with blood tests or dose adjustment.”

Twenty-three Ashford and St. Peter's Hospitals NHS Trust patients were invited to take part in the study which involved 18,113 patients world-wide and ran from December 2005 – December 2007. To fit the right medical criteria they had to have Atrial Fibrillation and some additional risk factors.

Said Sister Hamper: We are very grateful to all those who helped us with this important piece of research. For the patients it was a large commitment which involved frequent visits to the hospital, particularly at the beginning of the study. In the Trust we were well supported by the anticoagulant nurses as part of their role is to care for patients on Warfarin.”


Following the success of the study the next stage is for Dabigatran to be licensed for world-wide use, and approved for use in the NHS. It is not yet available.

Last Updated ( Tuesday, 17 November 2009 16:35 )