Warfarin Institute of America
DEDICATED TO YOUR HEALTH SINCE 2000
Why do I have to take warfarin to prevent stroke when some people only have to take an aspirin every day? - JP
There are several different reasons that a person may need to be on medications to prevent stroke. This is based on the person’s risk factors for stroke, which determine the type of stroke that particular person is most likely to experience. Ischemic strokes can be caused by clots (thrombi) in the carotid arteries themselves or by clots in the heart chamber that break off and travel to the brain. Clotting in the carotid arteries is most easily prevented using anti-platelet agents, such as aspirin1. Conversely, clotting in other parts of the vascular system is best prevented using anticoagulation agents, such as warfarin1. These clots in other areas of the circulation are often due to stagnation, which is present in conditions such as atrial fibrillation. Thus, patients with atrial fibrillation will most likely be on warfarin to prevent stroke while patients with atherosclerosis of the carotid arteries may be taking aspirin to prevent stroke.
Recent research compared aspirin vs. warfarin therapy for stroke prevention in patients with atrial fibrillation and showed that warfarin reduced stroke by 60%2. Alternatively, aspirin was shown to reduce stroke by only 20% in these patients. Another review compared warfarin and aspirin for prevention of stroke in patients with atrial fibrillation and a history of previous stroke and found that warfarin was significantly more effective than aspirin for preventing recurrent stroke3. Furthermore, a study compared the use of aspirin vs. placebo for preventing stroke in patients with atrial fibrillation and found that aspirin did not significantly reduce the risk of stroke alone4.
References:
1. Wijdicks E, Ferri F, Misulis K. Stroke – ischemic. FirstCONSULT, Copyright Elsevier 2007. http://0-www.firstconsult.com.library.uchsc.edu/fc_home/members/?urn=com.firstconsult/1/101/101448
2. Hart R, Pearce L, Aguilar M. Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients Who Have Nonvalvular Atrial Fibrillation. Ann Intern Med 2007; 146:857-867.
3. Saxena R, Koudstall PJ. Anticoagulants versus antiplatelet therapy for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attack. Cochrane Database of Systematic Reviews 2004, Issue 4. Art. No.: CD000187. DOI: 10.1002/14651858.CD000187.pub2.
4. Aguilar M, Hart R. Antiplatelet Therapy for Preventing Stroke in Patients With Nonvalvular Atrial Fibrillation and No Previous History of Stroke or Transient Ischemic Attacks. Stroke 2006;37;274-275.
©2007 Audra Patten
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Last updated June 27, 2007
