Recently diagnosed but not on warfarin yet. Is this right?

Hi all, I have had inoperable severe diffuse Cad for many years+ diagnosed with SVT few years back . Diagnosed with A fib 10 days ago and sent to AMU for assessment. Was told to see gp to discuss warfarin but when I went she said she couldn't do anything as she had not received discharge letter from hospital with their advice and as I was on low dose aspirin (one of my CAD meds) this would help to protect me from a stroke:-(

20 Replies

  • I'm not sure about treatment with CAD but with nonvalvular AFib anticoagulants are prescribed based on the CHADS2 score or better yet the CHA2DS2-vas score. Aspirin is not recommended, to reduce stroke risk, in Europe or many other countries if your CHADS2 score is 1 or greater or your CHA2DS2-vas score is 2 or greater. I think the AMA still recommends aspirin but if your score warrants it talk to your cardio about an oral anticoagulant (eg: warfarin, etc). Go online and look up the above acronyms to see how to calculate your scores.

  • Thanks for the advice. I do have a high score,


  • mzoren is correct... is a link to the chads2 explanation and you can test yourself. It is the Drs call but you need to understand why they are making their choice. I have spoken/written to 4 people in the last few weeks who were told by their Dr that they didn't think they were at risk, were not put on an anticoagulant and they had a stroke afterwards. My wife and I discuss this often. She does not like the blood thinners because of the side effects (and neither do I really) but the choice between the possible side effects and the 35% chance to have a stroke (that number comes from one of the most recent studies on AF clots) makes the choice easier.

    As far as the aspirin goes. There is a big debate about it. Most studies have concluded that aspirin has little effectiveness is preventing stroke in AF patients.


  • Thanks Tim -Yes I think I will have to risk the side affects against the risk of a stroke. Just hope I am put on it soon.


  • Chris I think you are the UK from your profile.

    Yes you can expect to be on warfarin this is much more effective than aspirin for the prevention of stroke, but usually in the UK this comes from a Anti-Coagulation clinic, I've not heard of any run by doctors, certainly round here they are Hospital based, the GP simply is a funnel for the prescription of the drugs, and you have to keep them informed of your progress (Little yellow book you will very quickly learn all about)

    You have not said if you have been referred to a cardiologist, and I am assuming that with the new diagnosis this will be the case, You certainly should be even with inoperable CAD, which I assume leaves you still under the Cardio unit at your hospital.

    Best of luck


  • Hi Ian - Yes I am in the UK :-)

    After the recent diagnosis of AF and the hospital assessment on the 8th , I was told to visit my GP thinking I would be put on warfarin pretty quickly given my history of heart disease , hypertension, family history etc. GP didn't seem too interested and apparently has to wait for letter from the hospital - as I wasn't given one - to be able to prescribe, but will let me know. As I was sent home at 12 midnight and the ward was in complete chaos I wonder if it will ever appear! I have since had several more shorter attacks but none for a few days. Am not seeing cardiologist on a regular basis as have been fairly stable on my heart meds for many years tho I can't do much.I can be referred back if necessary.

    I am not sure what to do next if I don't hear something soon but am trying not to worry incase it starts the AF again.



  • I had been on a 325mg aspirin therapy for over a year and was very concerned about stroke risk. I was offered Warfarin but my varied eating habits and schedule made it unlikely that I would maintain the required INR. I opted for Xarelto (Rivaroxaban), which was subsequently prescribed, and I've been taking it for a couple of weeks now.

  • How are you getting on with this ? Do you get Afib regularly?

    best wishes,


  • I am 73 and developed AFib, following surgery, about 4.5 years ago. I had few episodes for the 1st year and then had them several time a month, almost all starting while in bed or just returning to bed from the bathroom. I also had very hard palpitations, the kind you feel in your ears, almost every night. Although I could tell I was in AFib it was not disabling - I could get out of bed and function. I always self converted to NSR with 2-12 hours. Last July I was diagonsed with sleep apnea and starting sleeping with a CPAP machine. At the same time I also found out, through groups like this, that taking magnesium, taurine, and foods with potassium would help. Since then my palpitations have almost gone and if I get them they are very mild, not the hard episodes I used to have, and I've only had 3 Afib episodes since July.


  • Thanks - that is very interesting


  • normally the hospital you went to would have recomended wharfin. this will be followed up by your gp. regular blood test know as NRI will give you the results of how thin your blood gets.. it should be between 2 and 3. when I first went into hospital with AF they treated me as though I had had an heart attack, the cardioligist on duty that day diagnosed me straight away with AF and put me on wharfrin . I have been told that Af is not cureable but can be controlled by varios drugs. all I can sugest is take it easy and don.t over do it. and enjoy yourself. I have had AF for over the last 5 years and I take oversea

    holiday twice a year

  • hi watchdog- how do you manage for health insurance on your trips abroad?

    Mine was pretty expensive before i had this new diagnosis!

  • I belong to a group travel insurance ex police for me and the wife it cost £175 per annum, this is subject to be well enough to travel..I always see my gp for confirmation that I am fit to travel

  • Oh dear I was previously paying over £100 for a week in France for my husband's arthritis and my heart disease - some companies would not insure me anyway .Dread to think what it would be now. Anyway think we wont be venturing too far as we don't feel up to it.

    Hope you enjoy your trips,


  • I have had AF now for 5 to 6 years and have had 4 cardioversion. I do not let my illnes effect my holidays. as long as you tkae care you should do the same. I have in the past since taking early retirement taken at least three holidays a year I am now 73 and I am not going to let my age or illnes stop me from taking holidays. always remember if you are fit to travel then do so.

  • Hi Watchdog

    Just read your posting and want to thank you for indirectly sorting out my travel insurance. I have recently been diagnosed with AF and then went on to have a TIA and then a minor stroke. Insurance now a big problem,as we go to France quite often. My husband is a retired police officer so just applied for NARPO travel insurance which accepts all existing conditions. Brilliant.



  • In your shoes I would ring the hospital and ask to be put through to your cardio's secretary. She can chase up the letter and get it faxed to GP, especially if you arm yourself with GP's fax no.

    My warfarin ( and husband's)is managed by the coaguchek computer at the GP's surgery. Instant INR and dosing. My GP wanted the discharge letter first too but then I had felt I needed warfarin for two years so another week didn't strike me as crucial! This was because this area used chads score till recently but have now caught up and use chads2 vasc score.

  • Thank you all for your replies. I am now not feeling so stressed and will wait a few days in the hope of hearing from the GP. Am not sure with the chads2vasc scoring what to do about unstable angina. I had 2 episodes some years ago which were both times treated the same as MIs with blood thinners etc

  • Chris -S

    I expect you will stay on aspirin as well as that works for CAD patients. A relation of mine with CAD was on warfarin and aspirin

    Good luck with it all

  • Can anyone recommend a chads2 vasc. !!! Site that simpletons can understand?

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