Canadian Pharmacy Review on the New Blood Thinner Drug’s Effect on Acute Coronary Syndrome

An advisory panel to the U.S. Food and Drug Administration on Wednesday voted against a new use of a new blood thinner, Xarelto, to cut the risk of potentially lethal clots in people with acute coronary syndrome.  To buy Warfarin online is still one of the safest and most effective moves when it comes to blood thinning medications. 

Xarelto (rivaroxaban) is one of a new class of blood thinners that has been developed to overcome some of the problems that exist with the standard treatment, warfarin (Coumadin), which requires constant dose monitoring. The effectiveness of generic Warfarin coumadin also can be altered by certain foods and other medications. Xarelto is already approved for use by those with atrial fibrillation (irregular heartbeat) and by people who are having hip- or knee-replacement surgery. 

"What is not reflected in the sponsor's analysis are minor bleeding events," FDA reviewer Dr. Karen Hicks wrote in the briefing documents. "While it is true that these bleeding events typically do not lead to death or irreversible harm, these events may represent the biggest problem for both patients and health care providers if rivaroxaban is approved." 

"While reductions in [cardiovascular] death still trump these bleeding events, if rivaroxaban is approved, we should expect a number of bleeding events that will require medical attention," Hicks wrote. "Carefully selecting patients for rivaroxaban therapy will be necessary to mitigate these bleeding risks." 

In research presented at the American Stroke Association's International Stroke Conference in New Orleans in February, Australian doctors followed more than 14,000 people who took either Xarelto or warfarin for a median of two years. Of those patients, 136 had bleeding in the brain.

People who took Xarelto -- and suffered from the most common type of atrial fibrillation and didn't have heart valve damage -- were about one-third less likely to experience bleeding in the brain than those who took warfarin, the investigators found. Canadian pharmacy encourages doctors and patients to decide wisely when it comes to choosing the right drug. 

Acute coronary syndrome (ACS) refers to any group of symptoms attributed to obstruction of the coronary arteries. The most common symptom prompting diagnosis of ACS is chest pain, often radiating of the left arm or angle of the jaw, pressure-like in character, and associated with nausea and sweating. Acute coronary syndrome usually occurs as a result of one of three problems: ST elevation myocardial infarction (30%), non ST elevation myocardial infarction (25%), or unstable angina (38%). 

These types are named according to the appearance of the electrocardiogram (ECG/EKG) as non-ST segment elevation myocardial infarction (NSTEMI) and ST segment elevation myocardial infarction (STEMI). There can be some variation as to which forms of MI are classified under acute coronary syndrome. 

ACS should be distinguished from stable angina, which develops during exertion and resolves at rest. In contrast with stable angina, unstable angina occurs suddenly, often at rest or with minimal exertion, or at lesser degrees of exertion than the individual's previous angina ("crescendo angina"). New onset angina is also considered unstable angina, since it suggests a new problem in a coronary artery.