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Warfarin - Does It Help Prevent Strokes And Heart Attacks

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joko | 16:34 Sun 01st Sep 2013 | Body & Soul
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just curious really -

i know it thins the blood, so could very small occasional doses help lessen the risk for people of a certain age?

if so, i wonder how many people may have been saved from strokes and heart attacks if they'd taken this drug.

is there any danger of taking it in small doses when you dont 'need' it?

thanks
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Interesting question, to which you will get interesting answers.......

Yes, warfarin does help prevent strokes and hear attacks not by thinning the blood, but by increasing the time taken for the blood to clot.

Who should take warfarin is the interesting question:

Certainly patients with atrial fibrillation (irregular heart beat) or those with a predisposition to blood clots should be given warfarin.

Is warfarin superior to aspirin in preventing strokes and heart attacks?.........debatable, except for the above conditions, as the dangers of prophlactic warfarin is much greater than aspirin.

My thoughts in a nutshell and is not meant to be covering all aspects.
and Aspirin is much cheaper.
Can be prone to bruising and bleeding on it and both warfarin and aspirin need to be declared (and usually stopped) before an operation.
To answer your question joko - taking doses of warfarin occasionally without blood tests and medical supervision would be dangerous and very ill-advised.
Even small doses can over-anticoagulate some people, as everyone requires a different dose.
Warfarin should only be taken if there is a good medical indication because of the risk of bleeding.
...as I am sure Sqad meant to say!
Even people who do need it have very regular blood tests and the doses are altered continually.
yes

yes

and yes

Aspirin as Sqad points out is much cheaper and much better and works in a different better way (inactivates platelets)

Warfarin acts on the clotting cascade (later than platelets and pl activation) making the body produce PIVKA - proteins induced in Vitamin K's absence

Warfarin after heart attack to prevent another was abandoned in the seventies as a result of the major side effects (2% major bleeding) which kinda balanced the decreased in re infarction rate.
I am concerned that some here appear to be presenting Aspirin and Warfarin as interchangeable, potentially equal alternatives as prophylactic preventative treatments against strokes or heart attacks.

The drugs work differently, on different parts of the coagulation process, and are therefore both very useful for different types of conditions.It is therefore a mistake to present one as "better" than the other.

And both can have severe side effects,so neither should be taken as prophylaxis without medical consultation and monitoring, especially warfarin.

There has been a good study contrasting the efficacy of warfarin or aspirin in a very particular cohort of patients; in the treatment of patients who have suffered a heart failure but have a normal heartbeat. The conclusion to be drawn from the study would be as quoted on the NHS Choices website;

"These findings provide a good indication that warfarin and aspirin are both comparable as treatments, at least in people with heart failure, a normal heart rhythm and no apparent high risk of clots. The findings do not alter the current medical management of heart failure or clot-prevention, so it is likely that the choice between prescribing warfarin and aspirin will continue to be made on a case-by-case basis."

The study also had these major findings;
"Researchers found that there was no difference in the rate of clot-based strokes, bleeding in the brain or death in patients receiving aspirin compared with patients receiving warfarin."

and

"When strokes caused by clots (ischaemic strokes) were considered separately, warfarin was significantly better than aspirin at reducing the risk of stroke,"

http://www.nhs.uk/news/2012/05may/Pages/warfarin-aspirin-anti-bloodclot-trial.aspx

It would be wrong to present Aspirin and Warfarin as equal alternative treatments for all conditions, or to present one as "better" than the other.Both have value, used correctly.


Do certain foods naturally thin the blood also? I know my father who has to take warfarin is not allowed cranberry juice!
@ MrIncredible No, not so much. In the case of Cranberry Juice, it is thought that there are components within the juice that can synergistically interact with the Warfarin, potentiating its effects and therefore increasing the chance of uncontrolled bleeding. There is a range of foodstuffs that can have an effect on warfarin therapy by interfering with the metabolism of warfarin, rather than having anti-coagulant properties themselves;

http://news.bbc.co.uk/1/hi/health/3120206.stm
One thing mentioned here had crossed my mind a few times; I'm on oral chemotherapy and daily aspirin because I have thrombocythaemia. If I were to be involved in an accident or needed an emergency operation, am I in any danger, if there was no time to tell anyone I was on aspirin.
My father inlaw (who is also on warfarin) bit his tongue last christmas after eating cranberry sauce, He needed to spend the night in hospital! I assumed it was because these just naturally thinned the blood, Thanks for the link lazygun.
\\\\\\Interesting question, to which you will get interesting answers....... \\\\

That was my first paragraph to my first answer on this thread and i haven't been disappointed..;-)

It is difficult on a general forum to know exactly at what level to pitch one's answer...too low and it is immediately commented upon or too high (especially with medical and scientific links) which mean very little to the average ABer and on many occasions, as medically qualified, I struggle to understand.

The first question is, that I ask myself, is what does the OP want to know and i try to answer as simply as possible.

In this case:

\\\\\\\Warfarin - Does It Help Prevent Strokes And Heart Attacks\\\

In simple terms, should one take either aspirin OR warfarin to prevent heart attacks OR is aspirin better than warfarin with prophylaxis in mind.

That is my idea of what joko is asking.

In my opinion, the answers have confused him:

Only in certain circumstances is anticoagulants beneficial in preventing heart attacks and\or strokes and this is based on individual requirements of specific disorders.

If one needs or thinks that long term anticoagulant therapy is beneficial for the prevention of strokes and\or heart attacks then aspirin IS better than warfarin on the basis of cost and side effects.
Indeed Sqad the main question was "does warfarin help prevent strokes and heart attacks", (which has quite a complicated answer - it all depends on the individual's risk) but then she went on to ask
"I know it thins the blood, so could very small occasional doses help lessen the risk for people of a certain age?" and
"is there any danger of taking it in small doses when you dont 'need' it ?"
The thought that it might be advisable for someone of a certain age to take the occasional warfarin tablet unsupervised needed to be corrected.
You know I like to keep things simple...
slaney...;-) yes I agree, perhaps i should have put more emphasis on the OP's ultimate question.
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thansk all

i wasn't intending to do it, nor advise anyone else too, i was just wondering if there was any use in doctors treating people, if it could be used in that way in the future - i wondered why it wasnt already
My mother, who was already on a low aspirin dose, suffered a stroke a couple of months ago and when the topic of Warfarin arose at the hospital we were advised that the dose has to be carefully managed depending on several factors including age, and that there was insufficient historic data on people of her age group (98) to start what would initially be "experimental" doses.
I should imagine the results of the blood test for Warfarin (INR) is what dictates the dosage you need to take. Probably wise to ask your doctor.

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