People taking warfarin need to have their blood tested regularly to make sure they're getting the correct amount. (Ed Andrieski/Associated Press)

People with a heart rhythm problem could be treated with a drug that is safer and easier to use than warfarin, currently used to treat the condition.

For decades, people with atrial fibrillation and other conditions have taken warfarin to reduce their risk of clotting and stroke.

Warfarin, also used as a pesticide against rats and other rodents, interacts with some foods and drugs, and patients taking it must have their blood tested regularly to check they are getting the correct amount.

A new drug, dabigatran, is as effective as warfarin in preventing stroke in patients with atrial fibrillation who have previously had a stroke or mini-stroke known as a transient ischemic attack, or TIA, according to a study in Sunday's online issue of the journal the Lancet Neurology.

Hans-Christoph Diener of the neurology department at University Hospital in Essen, Germany, and his co-authors randomly assigned 18,113 patients to take either dabigatran or warfarin. Participants were followed for an average of two years.

Dabigatran will prevent more stokes and save lives, said study co-author Dr. Stuart Connolly, head of the cardiology division at McMaster University in Hamilton, Ont.

"This is the first new blood thinner to come to the market in Canada," Connolly said. "It's a major new advance."

Since patients taking dabigatran don't need to have their blood monitored like with warfarin, more people will be able to take it, Connolly said.

Cost question

New guidelines in stroke and cardiac care recommend the use of dabigatran for most patients with atrial fibrillation, said Dr. Stephen Phillips, a stroke neurologist in Halifax who helped develop the recommendations for the Canadian stroke strategy.

But the new drug is expensive and is not yet on provincial lists for covered drugs, Phillips noted.

"I think that the cost element is probably the biggest barrier," Phillips said. "It's certainly the thing that's very unclear at this time because the drug has just been approved by Health Canada."

As with any new drug, Phillips suggested, doctors should prescribe dabigatran with caution until it has been tried out in a bigger population than the one used in a clinical trial.

Atrial fibrillation affects an estimated 250,000 Canadians.

Dabigatran has also been studied for the prevention of deep vein thrombosis, and is approved in Canada for some types of patients, Connolly said.

The study was funded by Boehringer Ingelheim, which developed dabigatran.