The outcomes to be assessed are recurrent ischaemic stroke, intracranial haemorrhage, myocardial infarction, parenchymal embolism and vascular death. Should these outcomes be significantly reduced, the public health and economic issues which will be addressed in this study are considerable. Approximately 40,000 new and recurrent cases of stroke occur in Australia each year, and about 80% of these are ischaemic. There is an average prevalence of about 20% of large or complex aortic plaque among p ....The outcomes to be assessed are recurrent ischaemic stroke, intracranial haemorrhage, myocardial infarction, parenchymal embolism and vascular death. Should these outcomes be significantly reduced, the public health and economic issues which will be addressed in this study are considerable. Approximately 40,000 new and recurrent cases of stroke occur in Australia each year, and about 80% of these are ischaemic. There is an average prevalence of about 20% of large or complex aortic plaque among patients with ischaemic stroke. About the same proportion of cases of ischaemic stroke yearly are associated with the presence of complex aortic plaque alone, and as many again with simple plaque (40% in total). Using the NHMRC estimated cost of $40,000 per stroke (and assuming that recurrent stroke costs are similar to initial stroke costs) and the estimated recurrent stroke rates of 11.9-100 person-years for plaque > 4 mm, the national cost of recurrent ischaemic stroke attributable to complex aortic plaque alone is about $3 million in the first year. This estimate does not include patients with incident TIA and atherosclerotic plaque or the resources spent on evaluating recurrent stroke and TIA attributable to aortic plaque, the cost of lost wages, or the negative impact on the quality of life of the victims. The economic and public health burden to our society could be greatly reduced by successful efforts at secondary stroke prevention in individuals with aortic plaque and TIA or ischaemic stroke. If just 25% of recurrent ischaemic strokes associated with aortic arch debris could be prevented by treatment interventions, the annual savings to society for recurrent ischaemic stroke alone would be considerable.Read moreRead less
Interactions Between Herbal Medicines And The Anticoagulant Warfarin
Funder
National Health and Medical Research Council
Funding Amount
$440,250.00
Summary
Complementary medicines are used widely in our community. Products are advertised as safe despite the fact that many have never been systematically tested for either efficacy or safety. Little is known about the potential for herbal medicines to interact with conventional medicines which may lead to potentially serious consequences. Clinical reports suggest that there is potential for an interaction between warfarin and herbal medicines. Interactions with warfarin in patients receiving the drug ....Complementary medicines are used widely in our community. Products are advertised as safe despite the fact that many have never been systematically tested for either efficacy or safety. Little is known about the potential for herbal medicines to interact with conventional medicines which may lead to potentially serious consequences. Clinical reports suggest that there is potential for an interaction between warfarin and herbal medicines. Interactions with warfarin in patients receiving the drug as part of their therapy can be life threatening. Identifying and avoiding significant drug interactions with warfarin can reduce patient problems caused by excessive bleeding, reduce length of hospital stay and decrease the need for frequent blood monitoring. The present study design will also provide a valuable insight into possible interactions with other medicines by understanding the mechanism of possible herb-drug interactions.Read moreRead less
A Case Control Study Investigating Factors Contributing To The Risk Of Bleeding In Patients Receiving Warfarin Therapy
Funder
National Health and Medical Research Council
Funding Amount
$572,242.00
Summary
Warfarin is a drug commonly used in the elderly to prevent blood clots. Blood clots can lead to stroke. While a very effective drug, it is also a dangerous drug because it can lead to thin blood which makes it more likely that they will bleed. For this reason, the drug should be closely monitored. We know that many people do suffer catastrophic bleeds because the blood is too thin directly as a result of taking warfarin. Some of the reasons for these bleeds are well known; they may be taking dru ....Warfarin is a drug commonly used in the elderly to prevent blood clots. Blood clots can lead to stroke. While a very effective drug, it is also a dangerous drug because it can lead to thin blood which makes it more likely that they will bleed. For this reason, the drug should be closely monitored. We know that many people do suffer catastrophic bleeds because the blood is too thin directly as a result of taking warfarin. Some of the reasons for these bleeds are well known; they may be taking drugs that interact with warfarin, they may have problems with their liver or kidney which affects the body's ability to get rid of it, they may have suffered a fall, to name a few. Studies done overseas have suggested that people are more likely to have a bleed if they do not know how to properly manage their tablets, if they are depressed, if they have no helpers to support them or if their care is not well organised. In Australia, we do not know what impact the organisation of care has on whether a person's warfarin is well managed. We do not know the impact that depression has on their care, or whether people are more likely to have pooorly controlled warfarin if they have few community ties. These are importnat questions to answer, so that we can make significant inroads into preventing death and disability from warfarin.Read moreRead less