New Health Report Exposes Imminent Risk of a Stroke Crisis in Europe

BRUSSELS, December 9 -

    - A report launched today by experts from medical and patient communities
      calls on Europe's policy makers to take urgent action against
      preventable strokes that strike thousands of atrial fibrillation (AF)
      patients each year



    - Affecting over six million people in Europe[1], AF, the most common,
      sustained abnormal heart rhythm, increases the risk of stroke five-
      fold[2] and is responsible for 15-20% of all strokes caused by blood
      clots (ischaemic stroke)[2],[3]

    - The consequences of stroke can devastate not only a patient's quality
      of life[4], but also that of families and carers[5]

    - The economic burden of stroke on the European economy is estimated at a
      staggering EUR 38 billion per annum[6]

    - The impact of stroke is predicted to rise dramatically as the number of
      individuals affected by AF is expected to increase 2.5 fold by
      2050[7],[8] due to an ageing population[7] and improved survival of
      patients with conditions which predispose AF (e.g. heart attack) [9]

    - Many AF-related strokes could be prevented by earlier detection and
      improved treatment of AF[10]

Urgent coordinated action is needed to avoid the thousands of preventable
strokes that leave many atrial fibrillation (AF) patients mentally and
physically disabled or dead, every year. A report, How Can We Avoid a Stroke
Crisis?, launched in the European Parliament today by Action for Stroke
Prevention, a group of health experts from across Europe, proposes measures
to tackle stroke in patients with AF, the most common, sustained abnormal
heart rhythm and a major cause of stroke[1]. Their proposal, endorsed by 17
leading European medical professional and patient organisations, calls for EU
policy makers and Member State governments to act before the increasing
frequency of these strokes becomes a major public health crisis.

The Report warns of a stroke epidemic across Europe, if actions are not
taken now to slow the rising tide of preventable strokes occurring every
year. Linda McAvan, Member of the European Parliament (MEP), commented, "It
is important that government and healthcare policy makers take action to
address the unmet medical needs in stroke prevention. I support the
recommendations made in the Report by Action for Stroke Prevention, and
believe that their implementation will contribute to the prevention of stroke
in patients with AF and, in turn, reduce the dramatically increasing
clinical, economic and social burden of stroke in Europe."

Recommendations made by the Report include: improving patient education
and stroke risk assessment, taking new approaches to prevention,
facilitating the exchange of best practice between Member States, developing
strategies to support adherence to guidelines, and the provision of equal and
adequate administration of therapy for patients with AF.

Unmet medical need to prevent stroke in atrial fibrillation patients

"It is clear that there is an unmet medical need for stroke prevention in
atrial fibrillation patients," said Professor Gregory Lip, Professor of
Cardiovascular Medicine, from the University of Birmingham Centre for
Cardiovascular Sciences, City Hospital Birmingham, UK. "The majority of such
strokes are preventable but the under-diagnosis and poor management of AF
patients, as well as suboptimal use of anticoagulation and side-effects of
current treatments, mean that an unnecessary and heavy burden is placed on
patients, their families and carers, as well as our healthcare systems."

Stroke is the most common cardiovascular disorder after heart
disease[11]. Current trends predict that the number of strokes in the EU will
rise from 1.1 million per year in 2000 to 1.5 million per year by 2025[12].
Furthermore, AF related strokes are more severe, cause greater disability and
have a worse outcome than strokes in patients without AF. People who have a
stroke caused by AF are more likely to remain in hospital for longer, are
less likely to be discharged to their home and are 50% more likely to remain
disabled[3],[13].

"The impact of the physical, emotional and cognitive disability on
patients following a stroke can be considerable," said Eve Knight, CEO,
AntiCoagulation Europe. "In turn, this can also have a profound impact on the
quality of life for the carer and family, who can suffer emotional problems
such as depression and anxiety."

The impact of stroke also stretches our healthcare systems. The economic
burden it creates accounts for 2-3% of total healthcare expenditure in the
European Union[6]. Healthcare costs associated with stroke are higher for
patients with AF than for patients without AF[14]. AF is a strong independent
risk factor for stroke and accounts for 15-20% of all ischaemic strokes
(strokes caused by blood clots)[2,3].

The number of people suffering from AF is around six million in Europe
alone[1]. People with AF are an important target population for reducing the
overall burden of stroke, which has been identified by the Heart Health
Charter and European Union policy as a key need in Europe[15].

About AF and stroke

AF is the most common, sustained abnormal heart rhythm[1]. It causes the
two upper chambers of the heart (the atria) to quiver instead of beating
effectively, resulting in blood not being completely pumped out, which in
turn causes pooling and can lead to clotting in the atria. If a blood clot
leaves the atria, it can become lodged in an artery in the brain blocking the
blood supply and causing the patient to suffer from an ischaemic stroke[16].
Approximately one in five ischaemic strokes are due to AF[3].

AF-related strokes are more severe, cause greater disability and have a
worse prognosis than strokes in patients without AF[3]. Although the current
treatment for stroke–vitamin K antagonists such as warfarin–can be
effective, they are also associated with a number of drawbacks and are
currently underused in Europe, especially in elderly patients at greatest
risk of stroke[17].

Preventing AF in patients at risk of arrhythmia, diagnosing AF before the
first stroke occurs and following recommendations regarding the use of
anticoagulation therapies, including potential new treatment options, are
critical for effective prevention of AF-related strokes[10].

About the Report

The authors are global leaders in cardiology, neurology, health
economics, policy and patient advocacy.

    The Report's call to action and recommendations are endorsed by:

    - ADKA (The German Society of Hospital Pharmacists)

    - AntiCoagulation Europe (ACE)

    - Arrhythmia Alliance (A-A)

    - Atrial Fibrillation Association (AFA)

    - European Society of Cardiology (ESC) Working Group on Thrombosis

    - European Association of Hospital Pharmacists (EAHP)

    - European Brain Council (EBC)

    - European Heart Rhythm Association (EHRA)

    - European Primary Care Cardiovascular Society (EPCCS)

    - European Stroke Organisation (ESO)

    - European Stroke Conference

    - German Competence Network on Atrial Fibrillation (AFNET)

    - International Council of Nurses (ICN)

    - Italian Atherosclerosis, Thrombosis and Vascular Biology (ATBV) Working
      Group

    - Sociedad Española de Neurologia (Spanish Neurological Association)

    - StopAfib.org

    - World Stroke Organization (WSO)

    The Action for Stroke Prevention alliance is financially supported by
    Bayer Schering Pharma AG.

References

[1] Kannel WB, Benjamin EJ. Status of the epidemiology of atrial
fibrillation. Med Clin North Am 2008;92:17-40

[2] Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation: a major
contributor to stroke in the elderly. The

Framingham Study. Arch Intern Med 1987;147:1561-4

[3] Marini C, De Santis F, Sacco S et al. Contribution of atrial
fibrillation to incidence and outcome of ischemic stroke: results from a
population based study. Stroke 2005;36:1115-19

[4] Wolfe CD. The impact of stroke. Br Med Bull 2000;56:275-86

[5] White CL, Poissant L, Cote-LeBlanc G, et al. Long-term caregiving
after stoke: the impact on caregivers' quality of life. J Neurosci Nurs
2006;38:354-60

[6] Allender S, Scarborough P, Peto V et al. European cardiovascular
disease statistics 2008 edition.
www.heartstats.org/uploads/documents%5Cproof30NOV2007.pdf. Accessed
November 2009

[7] Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial
fibrillation in adults: national implications for rhythm management and
stroke prevention: the AnTicoagulation and Risk Factors in Atrial
Fibrillation (ATRIA) Study. JAMA 2001;285:2370-5

[8] Miyasaka Y, Barnes ME, Gersh BJ et al. Secular trends in incidence of
atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and
implications on the projections for future prevalence. Circulation
2006;114:119-25

[9] Briffa T, Hickling S, Knuiman M, et al. Long term survival after
evidence based treatment of acute myocardial infarction and
revascularisation: follow-up of population based Perth MONICA cohort,
1984-2005. BMJ 2009;338:b36

[10] Kirchhof et al. Early and comprehensive management of atrial
fibrillation: Proceedings from the 2nd AFNET/EHRA consensus conference on AF
entitled 'Research perspectives in AF', EurHJ 2009

[11] World Health Organization. The global burden of disease: 2004
update.
www.who.int/healthinfo/global_burden_disease/2004_report_update/en/ind
ex.html. Accessed November 2009

[12] Truelsen T, Piechowski-Jozwiak B, Bonita R et al. Stroke incidence
and prevalence in Europe: a review of available data. Eur J Neurol
2006;13:581-98

[13] Lamassa M, Di Carlo A, Pracucci G et al. Characteristics, outcome,
and care of stroke associated with atrial fibrillation in Europe: data from a
multicenter multinational hospital based registry (The European Community
Stroke Project). Stroke 2001;32:392-8

[14] Bruggenjurgen B, Rossnagel K, Roll S et al. The impact of atrial
fibrillation on the cost of stroke: the Berlin acute stroke study. Value
Health 2007;10: 137-43

[15] Health-EU: Cardiovascular disorders.
ec.europa.eu/health-eu/health_problems/cardiovascular_diseases/index_e
n.htm. Accessed November 2009

[16] NHS Choices. Atrial fibrillation. 2007
www.nhs.uk/Conditions/Atrial-fibrillation Accessed November 2009

[17] Olsson SB, Helperin J. Prevention of stroke in patients with atrial
fibrillation. Seminars in Vascular Medicine 2005;5(3):285-92

(Due to the length of the above URLs, it may be necessary to copy and
paste the hyperlinks into your Internet browser's URL address field.
Remove the space if one exists.)

    Contacts

    Lucy Yeatman
    lyeatman@ruderfinn.co.uk
    T: +44-20-7462-8957

    Wioletta Niznik
    wniznik@ruderfinn.co.uk
    T: +44-20-7462-8913

Contacts: Lucy Yeatman, lyeatman at ruderfinn.co.uk, T: +44-20-7462-8957; Wioletta Niznik, wniznik at ruderfinn.co.uk, T: +44-20-7462-8913