Living with Warfarin

Anticoagulation with warfarin is not recommended for afibbers with no underlying heart disease or other risk factors for stroke.[1,2] However, in patients with a history of prior stroke or TIA (transient ischemic attack) and in those with prosthetic (artificial) heart valves the use of warfarin is likely to be beneficial overall. Many patients with less serious stroke risk factors such as hypertension and diabetes are also prescribed warfarin although it is somewhat doubtful whether the reduction in ischemic stroke risk outweighs the increase in the risk of serious bleeding and hemorrhagic stroke. A recent study of atrial fibrillation patients on warfarin found that the risk of major bleeding was 2.5% a year in the case of uncontrolled hypertension. [3] This compares to an ischemic stroke risk of 1.5-2.8% a year when on warfarin.[4,5] This is not a significant difference.