Just starting on Warfarin and I have a question. We are told that with AF we are something like 5 times more likely to suffer a stroke than someone similar without AF. On warfarin by how much are those odds reduced? Twice as likely? More? Less?
Anyone know what the stats tell us?
It all depends on your INR control. On everage risk is reduced by 60-70% - i.e. 2 to 3 times. If your control is good however, it's probably more like 4 to 5 times, in other words the same as someone without AF.
So INR control is critical. I've found a Coaguchek monitor to be excellent. I also take Vitamin K (in the form of K2 MK7) which helps to stabilise INR.
Mark
I also have a coaguchek monitor. Surprised you take vitamin K Mark as that is a known antidote to warfarin. Are you prescribed this or do you take it off your own bat so to speak. I really think you should discuss this with the anticoagulant clinic Surely you would be better reducing or increasing warfarin. There is the ACE site which is for people on anticoagulants that you might find useful
Hi MKB,
Vitamin K is a recommended means of achieving stability on warfarin, see
medscape.com/viewarticle/51...
However Vitamin K can promote arterial calcification, so a solution to this is to use VIT K2 instead of Vit K. See the following article:
bloodjournal.hematologylibr...
which discusses the merits of Vit K supplementation for INR stability.
You will need to scroll down to the 2nd page to get to the two letters. The letters discuss the benefits or otherwise of buffering warfarin dosage with Vit K to achieve stability of INR.
The first letter suggests that Vit K1 could be a potential danger as it could actually increase arterial calcification. Instead for buffering warfarin it suggests K2, in particular MK7. The second letter reiterates that the advantages of Vit K1 for stabilising warfarin outweigh any increased calcification risk.
I have discussed this with my EP and he agrees. Unfortunately there are still some anti-coagulant clinics that believe the outdated advice that Vit K should be minimised.
MarkS Is this the only study?. 8 people doesn't sound many for a trial. I can see the logic though.
I'm starting Warfarin after Easter ( going away, been on aspirin for two years have had three AF episodes in total). My GP is very anti me getting a coagucheck machine ( though OH is on Warfarin too) They use coagucheck at surgery so instant INR result and it is an excellent practice so don't want to rock the boat!!
It's a common misconception that aspirin is safer than warfarin in terms of the risk of major bleeding, particularly in the elderly. Evidence suggests neither can avoid major bleeding more than the other. However, there is compelling evidence that demonstrates warfarin significantly reduces the risk of stroke.
The Royal College of Physicians in Edinburgh brought together experts to examine the treatments in AF. They concluded that aspirin was not effective in preventing strokes caused by AF.
The 2012 European Society of Cardiology guidelines highlight that aspirin has no role in prevention of AF-related stroke, and should only be considered in patients refusing treatment with an oral anticoagulant.
Overall, anticoagulants are about three times more effective at preventing AF-related stroke than aspirin. However, over 230,000 people with AF in the UK are prescribed aspirin.
Am not doubting the Vit K thing was just very surprised because the amount of VIt K you eat in your diet definitely affects my INR. So do you have to restrict your normal intake if you are taking Vit K supplements
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