Stopping anti-clotting drugs for afib may raise stroke risk
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- Reviewed by Christopher P. Cannon, MD, Editor in Chief, Harvard Heart Letter; Editorial Advisory Board Member, Harvard Health Publishing
Older people with atrial fibrillation are sometimes advised to stop taking clot-prevention drugs due to concerns about dangerous bleeding in the gut or brain. But new findings suggest that the risk of stroke and heart attack from stopping anti-clotting drugs outweighs the risk of bleeding. The study relied on data from more than 20,000 people ages 75 and older who were prescribed an anti-clotting drug between 2013 and 2017. About half were taking warfarin; the other half were taking one of the newer anti-clotting drugs known as DOACs — most commonly apixaban (Eliquis) or rivaroxaban (Xarelto). Researchers found that compared to periods when people were on the drugs, their risk of stroke tripled and their risk of heart attack nearly doubled when they were not using the drugs. Although people were less likely to experience minor bleeding when they weren't taking the drugs, the risk of serious bleeding wasn't appreciably lower compared to when they were taking the drugs. The study was published online Feb. 17, 2025, by the journal Heart.
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About the Author
Julie Corliss, Executive Editor, Harvard Heart Letter
About the Reviewer
Christopher P. Cannon, MD, Editor in Chief, Harvard Heart Letter; Editorial Advisory Board Member, Harvard Health Publishing
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