Preventing Stroke With Anticoagulants in AF Patients

Dr. Paul Dorian, MD, CM, MSc., Cardiologist, discusses atrial fibrillation and the important role that anticoagulants play in preventing stroke.

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Dr. Paul Dorian, MD, CM, MSc., Cardiologist, discusses atrial fibrillation and the important role that anticoagulants play in preventing stroke.
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Featuring Dr. Paul Dorian, MD, CM, MSc., Cardiologist

Duration: 3 minutes, 12 seconds

Stroke is one of the most feared complications of atrial fibrillation. About one in every five strokes in North America is caused by atrial fibrillation, and if you have atrial fibrillation, your chances of having a stroke are about sixfold higher than in a similar person who doesn’t have atrial fibrillation.

Most strokes in atrial fibrillation unfortunately, lead to permanent disability from paralysis or inability to talk, or walk or speak. Stroke in patients with atrial fibrillation is caused by blood clots, which form in the heart and then dislodge and go to the brain, stopping blood from getting to the brain cells, and when brain cells die, you get a stroke because your brain doesn’t function anymore.

Anticoagulants are sometimes known as blood thinners. They’re not actually blood thinners, what they are is anti-clot agents, and these are drugs that prevent the blood from clotting when it is in the heart.

It’s important to know that the blood still clots, even if you’re on an anti-clot agent. So people don’t bleed to death; they are more likely to bleed if they cut themselves, for example, but these anti-clot agents are basically very effective at preventing these clots from forming in the heart, and then dislodging and going to the brain or other organs.

There are different kinds of anticoagulants, known as blood thinners, that patients and doctors can use. The choices are generally made between patients and doctors after a discussion, which we call shared decision making.

The traditional blood thinner, which has most frequently been used in the past, is called Warfarin, sometimes known as rat poison. Warfarin has been around since the 1950s, and it is very effective at preventing clots and reducing the risk of stroke.

Unfortunately, Warfarin is a complicated drug to take, and there are now – in North America and worldwide – at least three and soon four other newer blood thinners, so-called novel oral anticoagulants, are taken once or twice a day, and do not need monitoring.

In other words, one size fits all, so to speak, and the doctor makes a decision as to what the right dose is for that particular patient, and the patient then takes the medication and is followed up by their doctor. Usually every six months or as infrequently as every year.

It’s very important that patients have a detailed discussion with their doctors and their pharmacists to make sure that they’re taking their medications appropriately. It’s important to know that medications only work if you take them regularly, exactly as instructed.

Missing doses or stopping the medication – even temporarily – can put patients at risk for stroke. This is a conversation that is very important to have with your family doctor, with your cardiologist if you have a cardiologist, and your pharmacist to make sure that you’re taking the medications exactly as recommended in the right time frame, and that you don’t miss any doses. This is an ongoing challenge for patients and for doctors, to make sure that the medicines are taken exactly as they’re supposed to be taken.

Presenter: Dr. Paul Dorian

Atrial Fibrillation Video Quiz ( 186 participated.)

Stroke Prevention with Anticoagulants

Questions True False  
1 Warfarin is the safest and easiest blood thinner to take on the market today.

 
2 Anticoagulants, also known as blood thinners should be taken every day in patients with atrial fibrillation in order to help prevent blood clots forming and traveling to other parts of the body, including the brain which then cause a stroke.

 
3 Patients with atrial fibrillation are 5 x more likely to have a stroke than the general population.

 
4 Compliance with blood thinners is very important for patients with atrial fibrillation. Missing just one dose can put a patient at risk of a stroke.

 
5 Newer blood thinners on the market today have improved compliance as they do not require regular blood testing and can be taken once a day.

 
6 Newer blood thinners on the market are just as safe and effective as Warfarin.

 
7 Atrial fibrillation patients are safest when they take their blood thinners every day and don't miss any doses.