Going without anti-coagulation meds?

[Ovie]

I read an article, something that I found through google that I've been trying to find again. But it was based on patients with mechanical valves that did not take anti-coagulation meds, there were 3 patients they spoke of in particular and it was something like 3 years, 6 years, and 7 years they had been without the meds and still alive.

I'm curious, this isn't a route I'm obviously looking to take but if I stopped taking my warfarin, how long do you think I'd be able to survive? or anyone for that matter? These 3 obviously have tested and done alright, but I just wonder what if something happened in the world, and I wasn't able to access my meds, would I basically be a walking dead man? Is stroke usually the main case of lack of meds?

What are your thoughts?

 

[ski girl]

Ovie I think I read somewhere that mechanical valvers in Europe don't take anti-coag meds at all, that the medical establishment there doesn't think it's necessary. I don't know where this came from but maybe someone else has seen it too?? (I think I'll just need to get googling!)

 

[Ovie]

Yeah, it wasn't in the US, it was a European article that I stumbled across late one night. Just found it interesting because I had a read on here a thread about what if there was some kind of economic downfall and access to our meds was denied. I just wonder if we are the first to go without our Coumadin/Warafin/others.

 

[dwhist]

This article talks about a person who has gone 23 years

http://icvts.oxfordjournals.org/content/8/2/263.full

 

[dick0236]

......... and I wasn't able to access my meds, would I basically be a walking dead man? Is stroke usually the main case of lack of meds?

What are your thoughts?

I REALLY don't advise this!!!! I went on a fishing trip 39 years ago and forgot to take my warfarin with me. I went four or five days without the drug and suffered a stroke shortly after returning home. That is the ONLY problem I have had in the 46 years I have been on the drug. Odds are that not taking warfarin will not kill you but the risk of disability due to a stroke is VERY real......been there, done that, and it ain't no fun. Now I have two lifelong health problems...an artificial heart valve AND 50% blindness from my stroke.

The new valves, according to what I've read, may require a lower INR, but I would be VERY, VERY careful about going off the drug.......and certainly not without a skilled doctor(s) input.

 

[newmitral]

I would first echo Dick's warning that this is not something to be tried.

Nevertheless, from a statistical viewpoint, I listed several references back in this thread:
http://www.valvereplacement.org/forums/showthread.php?40872-Bridge-comadin-for-surgery
which say that the risk of thrombus formation on the valve and subsequent embolism without any antithrombotic treatment
averages about 10% per year.

So, if you accept the 10% probability per year of major stroke in the absence of anti-coagulation, you will have a 50-50 probability of being dead in about 6.5 years. Your odds of living 10 years would be reduced to about 34%. Your odds of living 15 years without anticoagulation would be only about 20%.

So, you are not guaranteed instant or immediate death upon the cessation of your warfarin, but why kick the odds up to 10% from the 1% or 2% per year that you have when you do take the warfarin?

I'm not sure if non-fatal strokes are counted in the 10%/year figure, and if you count those, my suspicion is that the odds are even more strongly against you if you stop the ACT.

 

[Ovie]

oh no, don't get me wrong..this is not something I'm going to do, but curiosity hit me when I read that article, about what IF there was a lost of government or something, and order was lost. Those of us who rely on the meds would be in trouble, or if it's something that we could end up managing.

 

[Protimenow]

If warfarin was to suddenly become unavailable, it would be easy to find people who went one year, two years, maybe even 10 or 20 years, without taking the medication. THE REST WILL HAVE DIED ALONG THE WAY.

The real question would be what PERCENT of those who stopped taking warfarin survived for those periods of time -- it wouldn't be about those who were left (whose bodies perhaps didn't respond to the artificial device by forming clots on it).

I've been pretty diligent about my dosing, too, but last year, in a combination of trusting my meter too much, and going too long between tests, I had a TIA (otherwise referred to as a Stroke). I've learned not to trust the accuracy of my meter - to test weekly - and to try to stay in range. I know that, for myself, my body CANNOT go for extended periods without adequate anticoagulants.

Warfarin is very inexpensive. I see little risk that it will become unavailable. For a dime or two a day, it just isn't worth the risk to stop taking it....regardless of the fact that there are some long term survivors in Europe who aren't taking it. (Interesting thought -- if there's a common factor in the people who survive without warfarin, it may be interesting to know what that factor/those factors are - and perhaps to be able to identify those who don't need to worry about anticoagulants. Imagine - a couple million dollars of research, so society can save a few thousands of dollars per lifetime for the meds).

 

[ski girl]

A quote from that article:
Andersen and Alstrup followed 43 patients (mean age 52 years) who discontinued anticoagulation after 12 months of isolated mechanical aortic valve replacement and were followed for a mean period of 7.2 years without anticoagulation [3]. They noted after 10 years, 41% incidence of thromoboembolic events and 17% mortality.

I think I'll stay with my warfarin!

 

[Ovie]

Yeah, I'll stick to it also.

 

[Julian]

A quote from that article:
Andersen and Alstrup followed 43 patients (mean age 52 years) who discontinued anticoagulation after 12 months of isolated mechanical aortic valve replacement and were followed for a mean period of 7.2 years without anticoagulation [3]. They noted after 10 years, 41% incidence of thromoboembolic events and 17% mortality.

I think I'll stay with my warfarin!

Holy moly! I don't like those odds... That kinda makes me want to ask if the risk is about 50 percent at 10 years and if that's true that might mean that those that go 10 years might possibly in a far stretch of hopeful guessing may have a super high tolerance and probably won't ever develope clots on foreign objects in the body. I kinda like protimes suggestion about doing research on this. There is a realistic chance that some people just don't need anticoagulants. In the future this maybe determined by a simple blood test... :thumbup:

 

[yotphix]

Hey Ovie! If there is a new 'dark ages' suddenly, you can always take to eating fermented sweet clover, which contains the substance coumarin, which was the inspiration for the synthesis of warfarin. It won't be as easy to control, but it might keep us alive in that very unlikely event!

 

[Jkm7]

If the circumstances are so bad you can't get life sustaining meds, one might be happy to not sustain life long term. I know there are 'survive at any price' people among us but I wonder if there aren't some who are not that driven to survive in any and all circumstances?

 

[pellicle]

If the circumstances are so bad you can't get life sustaining meds, one might be happy to not sustain life long term.

sounds like a view presented in "the Road"

challenging movie

 

[Jkm7]

No one needs to agree with me.
JMO

 

[Bina]

If for some crazy reason I had no access to Coumadin/warfarin, I would at least be eating generous portions of garlic, and taking daily Aspirin.

 

[njean]

If for some crazy reason I had no access to Coumadin/warfarin, I would at least be eating generous portions of garlic, and taking daily Aspirin.

....and you'd be safe from 'Dracula' ...

 

[Bina]

....and you'd be safe from 'Dracula' ...

Yeah, no kidding.

 

[pellicle]

If for some crazy reason I had no access to Coumadin/warfarin, I would at least be eating generous portions of garlic, and taking daily Aspirin.

Don't forget the red wine too!

;-)

 

[pellicle]

No one needs to agree with me.
JMO

Sorry, it wasn't about the topic, just it reminded me of that movie is all.