If I have atrial fibrillation, how can I lower my risk of stroke?

Medications can reduce the risk of stroke if you have atrial fibrillation (AF).  The drug warfarin (generic) or Coumadin (brand name) can reduce the risk of stroke from clots in AF patients. Several important clinical research studies have shown that this blood-thinning medicine reduces the risk of stroke by about two-thirds. Regular blood tests called INR are needed to check that the dose is safe. An INR that is safe and effective should be between 2 to 3. A slightly higher INR between 2.5 and 3.5 is recommended for patients with artificial mechanical valves.  Higher INR numbers can cause bleeding problems. You need to report unusual bleeding gums, bruises or blood in the urine to your doctor immediately. INR numbers lower than 2 can mean increased risk of stroke.

It is important to monitor and adjust the dose of blood-thinning medication when any changes are made to other medications you take. Always check with your physician or pharmacist before starting any new medications or over-the-counter supplements. Let your other physicians know about medication changes as soon as possible, especially the doctor who regulates your blood thinner and monitors your INR. If serious side effects of warfarin occur or if there are other reasons to not take this medication, then your doctor may recommend one adult aspirin (325 milligrams) per day. There is no benefit to taking baby aspirin (81 milligrams) for the prevention of stroke when AF is present. Recently, a new medication acting as a blood thinner, called Pradaxa (dabegatran), has been used to prevent stroke from AF. It should be taken twice a day and there is no need to change the dose or monitor it.

The guidelines given by the American Heart Association and the American Stroke Association stress the importance of evaluating patients for atrial fibrillation (AFib), which can cause the heart to form clots that can break loose to cause a stroke. Warfarin (Coumadin), an anticoagulant, can decrease the risk of stroke from AFib by two-thirds. For those at high risk of bleeding from warfarin, the guidelines state that dual therapy with clopidogrel (Plavix) and aspirin offers more protection than aspirin alone, but the risk of bleeding is also higher than with aspirin alone. If you have AFib, discuss the stroke prevention options with your doctor.