PATIENTS in Scotland who are at high risk of heart attacks and stroke will be the first in the UK to benefit from a blood thinning drug shown cut their risk of serious cardiac events by a quarter.
The decision by the Scottish Medicines Consortium to make the drug, rivaroxaban, available to patients with stable coronary heart disease follows the results of a major global clinical trial involving more than 27,000 people, including UK patients.
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The COMPASS trial found that the combined risk of suffering one of three serious cardiac events - heart attack, stroke and cardiovascular death - was 24 per cent lower among patients taking rivaroxaban in combination with aspirin, than it was in patients on aspirin alone.
The drug, also known by the brand name Xarelto, is the first blood-thinning drug licensed to prevent blood clots forming in the arteries of people with high-risk coronary or peripheral artery disease.
The condition affects around 240,000 people in Scotland and it is estimated that as many as 110,014 could benefit from the new treatment within the first year.
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Professor John Cleland, director of the Glasgow Clinical Trials Unit and professor of cardiology at Imperial College London, said: “There have been few recent substantial advances in the medical management of coronary artery disease, which remains an area of substantial unmet need, particularly in Scotland.
“The COMPASS trial shows that adding rivaroxaban vascular dose to low-dose aspirin reduces vascular events. The reduction in vascular events outweighed the modest increase in major bleeding events.
“Conducted in more than 30 countries, including the UK, COMPASS was one of the largest ever trials of oral anti-thrombotic therapy providing robust results, overall, and for key patient subgroups at high-risk of recurrent events such as those with renal dysfunction or stable ‘mild’ heart failure.”
Around 15,000 people die from a heart and circulatory disease each year in Scotland, accounting for 26% of the nation’s deaths.
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Dr Alan Begg, a GP in Montrose and trustee of Chest, Heart, and Stroke Scotland (CHSS), said: “In Scotland, we’re only too aware that cardiovascular diseases carry an unacceptable burden, accounting for a quarter of all deaths.
“As GPs, we are always looking for new options for protecting our patients especially as, despite current treatment, the risk remains high.”
SMC Chairman Dr Alan MacDonald said:“For some patients at risk of heart attacks due to coronary artery disease, rivaroxaban provides a helpful new treatment option.”
Meanwhile, doctors writing in the British Medical Journal (BMJ) today have called for action to combat the “looming epidemic” of irregular heartbeat, also known as atrial fibrillation (AF).
Prevalence is increasing in Scotland and the rest of the UK, and the condition is associated with a heightened risk of heart failure, heart attack, strokes, and potentially dementia.
Writing in the BMJ, Dr Mark Lown, a GP and lecturer in medicine at Southampton University, said routine screening for atrial fibrillation had the potential to prevent strokes because at-risk patients could be prescribed blood thinning drugs.
He said: “The prevalence of AF is rising steeply and is associated with increased risk of heart failure, myocardial infarction, and death,and treatment with anticoagulation is associated with reduction in all these outcomes relative to placebo...Current evidence provides a strong case for introducing AF screening.”
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