Your healthcare provider will work
closely with you to find the right medicines for you to help prevent stroke. They
consider both your health history and your preferences.
Some of the medicines that your
provider may prescribe include:
- Antiplatelet medicines, such as
aspirin or clopidogrel
- Anticoagulation (blood-thinning)
medicines, such as warfarin, or medicines called direct-acting oral anticoagulants
(DOACs), such as dabigatran, rivaroxaban, apixaban, or edoxaban.
These types of medicines help to
prevent blood clots in different ways:
- Antiplatelet medicines affect
platelets, which are fragments of cells involved in clotting
- Anticoagulation medicines work on
other parts of the complex blood-clotting pathway in the body
Each person's risk for stroke is
evaluated on an individual basis. If you have risk factors for stroke, you will likely
need blood-thinning medicines.
Your healthcare provider may advise
DOAC medicines unless you have moderate to severe narrowing of the heart valve (mitral
stenosis) or a mechanical heart valve. With DOACs, no regular blood tests are needed
monitor how your blood is clotting. But you may need blood tests of your kidney and
liver function before starting these medicines and then every so often while you are
Warfarin is the medicine often
recommended for treatment of AFib in people who have moderate to severe mitral valve
disease or a mechanical heart valve. With warfarin, you need blood tests on a regular
basis to make sure the blood is clotting the right amount. Your healthcare provider
measure clotting with a prothrombin time test. This is sometimes called a PT or pro
test. The results are reported as the international normalized ratio (INR). The INR
standard way of reporting the PT by all laboratories. If your INR is too high, the
of warfarin may be lowered because you are at higher risk for bleeding. If your INR
too low, your risk for blood clots is higher. So your healthcare provider may increase
your dose of warfarin. Warfarin also interacts with certain foods. For example, foods
high in vitamin K, such as leafy green vegetables, can make warfarin less effective.
This could raise your risk for blood clots. That's why it is important to eat a
consistent amount of foods high in vitamin K.
Talk with your healthcare provider about the medicine prescribed to
learn all you can about it. Also, be sure all your healthcare providers know that
take blood-thinning medicines.
A device may be used to close off
the left atrial appendage in some circumstances, to prevent stroke without having
lifelong blood thinners. The left atrial appendage is the area within the heart where
most blood clots form. By closing this area off, any clots that form there cannot
out to travel to the brain to cause a stroke. The device is implanted without heart
surgery. This device is not appropriate for everyone. It is generally considered in
those who are at high risk for stroke, as well as high risk for bleeding. Even with
device, you may need to take blood thinners in the short-term.