Anticoagulants/Anti-Platelets as a Treatment for Patients with Heart Problems

Anticoagulant=blood thinner that makes it more difficult for the blood to clot (coagulate). They do not dissolve existing blood clots but prevent new clots from forming and from existing clots from getting larger.

Also known as blood thinners (although they really do not thin your blood), many patients with heart problems are prescribed anticoagulant medications. These are prescribed for people that are at increased risks for strokes because the most common stroke is caused by blood clots obstructing blood flow to the brain. For our purposes, anticoagulants are prescribed for others that are at increased risk for blood clots, such as those with an artificial heart valve or those with atrial fibrillation.

Three of the most commonly prescribed anticoagulants are Aspirin, Coumadin (generic: Warfarin Sodium) and Plavix. All of these drugs interfere with your body's natural ability to clot blood, which can be very dangerous in situations of large losses of blood (causes abnormal bleeding!). Therefore it is VERY important that these medications be taken exactly as prescribed!

Aspirin

Aspirin has an antiplatelet effect, which makes your blood platelets less likely to stick together and form clots. Aspirin is less likely to cause abnormal bleeding and is usually added in addition to a prescription anticoagulant.

Coumadin (Warfarin)

Warfarin is an anticoagulant that is more effective at preventing clot-caused strokes than Aspirin. Most people over age 60 with an atrial fibrillation will be prescribed a blood thinner. It has been shown that patients that have been taking Warfarin for a long period of time have reduced their chances of having a stroke by 70 percent or more! While the side effect of abnormal bleeding is a dangerous side effect, having a stroke is even more dangerous. It is important that it is taken exactly as prescribed. If a patient misses a dose, the patient should NOT take another one later to catch up. Always be sure to tell a new doctor, dentist, etc that you are taking Warfarin, especially when a new medication is being prescribed that may interfere or a procedure that causes bleeding.

Plavix

Anyone that has had one clot-related event (heart attack, stroke or heart-related chest pain) may be up to 9 times as likely to have another clot-related event. Plavix is the most researched (and one of, if not the most expensive) anti-platelet medicine. Many people take cholesterol and blood pressure medicines to help lower their risk of a heart attack or stroke. While reducing high blood pressure and cholesterol is extremely important, it’s also important to know that blood pressure and cholesterol medications do not directly address the formation of clots, which are the cause of most heart attacks and strokes. Therefore, blood pressure and cholesterol medications are NOT always ENOUGH to treat and prevent patients from having a clot-related event. Plavix addresses this important issue and is currently the #1 prescribed anti-platelet medication. The patient should not stop taking Plavix unless he or she consults their doctor first. Suddenly stopping Plavix can increase your risk of heart attack or stroke. People with stomach ulcers or conditions that cause bleeding should not use Plavix. Also patients that take any medication for heartburn or acid reflux (like Nexium or Prilosec) should not take Plavix.

While anticoagulants are not a direct treatment for arrhythmias, they are important in treating or preventing blood clots that may lead to a heart attack. Patients with atrial fibrillation are at increased risks for forming a blood clot in the upper chambers of their heart that can lead to a heart attack or stroke. Therefore, AF patients are commonly prescribed for anti-platelets. It is important to take these medications as prescribed because of the abnormal bleeding that can occur during surgeries or open wounds. But it is also important to remember that the abnormal bleeding is not as dangerous as the stroke or heart attack that can result from not taking these medications.