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About 2.7 million Americans have atrial fibrillation and are at a risk for having a stroke. Being over age 65, having a family history or past occurrence of diabetes, stroke, heart failure, heart attack, poor kidney function and high blood pressure, and being female are all factors that increase the chances of you having a stroke. However, the risk of having a stroke can be greatly reduced (by 50-60%) with the help of an anticoagulant (more popularly known as a blood thinner).
When blood flow is obstructed by a blood clot, cells in the brain can’t get enough oxygen, which causes a stroke. The top chambers of the heart of people with atrial fibrillation create a sluggish blood flow that often forms blood clots. If a part of these clots reaches the brain, a stroke can occur. Blood thinners are an ideal solution for this problem because they can reduce the formation of blood clots in the heart, which will decrease the risk for having a stroke.
Despite the success of blood thinners in reducing strokes, almost 50% of patients with atrial fibrillation fail to take blood thinners because of the potential for anticoagulants to cause bleeding and because they don’t feel noticeably better when taking the medication.
In the past few years, the FDA has approved four new blood thinners called edoxaban (Savaysa) dabigatran (Pradaxa), apixiban (Eliquis) and rivaroxaban (Xarelto). Like the popular blood thinner warfarin, these new medications are also used to decrease the odds of stroke in atrial fibrillation patients. One difference in these new drugs compared to warfarin is the lack of need to do blood monitoring.
Even though blood thinners prevent strokes by reducing the occurrence of blood clots from the heart, they increase the risk of strokes caused by brain bleeds (also known as a hemorrhagic stroke). Warfarin has been known to cause bleeding when it’s weakened by certain foods and medications that interact with its effectiveness. The newer medications cause fewer strokes from bleeding incidents compared to the older medication Warfarin and tend to fare better overall for reducing strokes from either bleeds or blood clots.
Consult with your doctor to ensure the treatment of your atrial fibrillation includes stroke prevention. Just because you have a mild case of atrial fibrillation does not eliminate the need to use a blood thinner as a precautionary measure. The other factors already mentioned can increase your odds of stroke even with mild atrial fibrillation, so make sure you are honest about your health history with your doctor so you can discuss better treatment alternatives.