Your healthcare provider will work
closely with you to find the right medicines for you to help prevent stroke. They will
consider both your health history and your preferences.
Some of the medicines that your
healthcare 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 red blood 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
recommend 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 to 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 taking them.
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 can
measure clotting with a prothrombin time test or protime (PT). The results are reported
as the international normalized ratio (INR). The INR is a standard way of reporting the
PT by all laboratories. If your INR is too high, the dose of warfarin may be lowered
because you are at higher risk for bleeding. If your INR is 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
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 you
take blood-thinning medicines.
A device may be used to close off
the left atrial appendage in some circumstances, to prevent stroke without having to use
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 get
out to travel to the brain to cause a stroke. 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 the device, you may need to take blood thinners in