A National Heart Research Fund study into the use of the anti-clotting drug Warfarin could benefit patients throughout the North-East. Health Correspondent Barry Nelson reports

MORE than 100 North-East patients are helping scientists improve the care of people with abnormal heart rhythms.

If the research project is successful, it could dramatically reduce the risk of potentially fatal internal bleeding faced by many heart patients on blood-thinning drugs. It could also lead to patients monitoring their own condition or having check-ups at their GPs rather than at a hospital.

A research team from Newcastle University has recruited 150 patients who are currently on the anti-clotting drug Warfarin. The £20,000 project is being funded by the little-known charity, the National Heart Research Fund.

The Leeds-based NHRF funded six of the first eight heart transplant operations and the world's first artificial heart device. Every year it backs around 55 heart-related research projects in the UK with an average cost of £45,000, including regular donations to North-East scientists. Specialists at the Freeman Hospital have benefited from grants from the NHRF totalling more than £80,000 in recent years.

While Warfarin helps protect thousands of heart patients from strokes caused by blood clots, there is a downside. Doctors find that up to 50 per cent of patients on Warfarin do not respond in a consistent way. One week they need more Warfarin to thin their blood and the next week the dosage has to be reduced.

What is worrying about these patients is they either have an increased threat of strokes because their blood is too sticky or an increased threat of internal haemorrhaging because their blood is too thin.

Dr Farhad Kamali, a clinical pharmacologist based at the Wolfson Unit at Newcastle's Royal Victoria Infirmary, says the study is the first attempt to find out why some heart patients on Warfarin fare badly. "We know the long-term effects of Warfarin are beneficial. Patients who are on this drug have a reduced chance of suffering a stroke," says Dr Kamali. "However, in some patients there is a risk of bleeding if the blood is over-thinned which can be fatal."

At the moment, patients on Warfarin are regularly monitored at hospital clinics to check whether the drug is working.

"While most patients are stable, up to 50 per cent can be out of control," says Dr Kamali. "We are studying three groups of patients to see if this problem is caused by people not taking the drug properly. The patients might not have the right education about Warfarin so we are asking around 100 patients to take part in an education programme about the drug."

Half the patients who undergo education courses have been given small blood coagulation monitoring kits which can be used at home.

Another 50 patients on Warfarin, who are not on a special education programme or equipped with home coagulation monitors, are being monitored to see if there is any change in behaviour between the three groups.

Dr Kamali says the outcome of the study could determine how heart patients are treated throughout the UK.

Ian Ackroyd, legacy officer for the National Heart Research Fund, says the charity relies heavily on people leaving money in their wills.

Well over half its income comes from this source.

See the adjoining panel for information on how you can make a free will and consider making a donation to the NHRF.