What You Need to Know about Anticoagulant Therapy

February 23, 2016 Brigham and Women's Hospital

Anterior cut of heart showing normal, healthy heart and conduction system vs. a damaged conduction system with arrows; ACardio_20140401_v2_001.ai SOURCE: cardiacsurg_maze_anat.ai

Anticoagulants are most commonly used to treat patients with atrial fibrillation, a type of irregular heart rhythm.

Anticoagulants (blood thinners) are oral medications that are used to treat several types of cardiovascular conditions. They are most commonly used to treat patients with atrial fibrillation, a type of irregular heart rhythm, but also to help patients with mechanical heart valves or those who have had blood clots in either their veins or arteries.

For many years, warfarin (Coumadin®) was the only anticoagulant treatment option available. In recent years, however, several new types of blood thinners have been shown to effective and safe, including dabigatran, rivaroxaban, apixaban, and edoxaban. These additional options are significant, as they can be preferable to warfarin in certain cases. The advantages of these newer drugs over warfarin include decreased risk of bleeding, no need for routine laboratory monitoring, and fewer interactions with foods and other drugs. The newer drugs, however, also have some limitations when compared with warfarin. These newer medications, for instance, are short-acting (having effects that last for a short time), which can create problems for patients who have issues with adherence. It also is easier to reverse the effects of warfarin when patients have a bleeding complication or overdose on their anticoagulant medication.

In the video below, Dr. Gregory Piazza, Division of Cardiovascular Medicine at Brigham and Women’s Hospital, discusses what patients need to know about warfarin and the newer blood thinners, including adherence, side effects, drug and food interactions, benefits and risks, activity restrictions, and medication options.

– Chris P.

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