unexpected new warning on my new warfarin supply

[carolinemc]

I switched cardiologists recently due to moving to a different city. The new cardiologist was surprised my old one had me (St Jude mechanical valve) on low dose aspirin as that is no longer a guideline. The most recent consensus is that low dose aspirin may increase bleeding events without preventing strokes (see https://www.amjmed.com/article/S0002-9343(24)00045-7/fulltext).

You should of course do what your doctor tells you, and I think a lot of doctors will be hesitant to stop prescribing aspirin as they have been doing so for years. But the science seems to indicate that there is no good reason to take aspirin with warfarin unless you are following a low INR warfarin regimen or you are at above average risk for stroke.

They did change guidelines. But it depends on your age, condition on the aspirin regiment. I was put back on the aspirin due to an eye stroke. And taking low dose warfarin has nothing to do with it. And when you have a different cardio, your condition will be treated differently, due to the doctor preference in treatment that is out there. Many of them to choose out there these days.

 

[3mm]

You should of course do what your doctor tells you

I suggest a slight modification of this statement.

Each of us should discuss our issues, our health, our test results, our medications, etc., with our doctors. Together with our doctors and our loved ones, we should reach a joint decision on our medical plans.

 

[Chuck C]

I suggest a slight modification of this statement.

Each of us should discuss our issues, our health, our test results, our medications, etc., with our doctors. Together with our doctors and our loved ones, we should reach a joint decision on our medical plans.

I totally agree. Our doctors are our consultants and we should trust them. But, we are the ones who live with the consequences of our choices, such as valve choice or INR range and some decisions ultimately come down to the patient.

 

[Habana58]

Did the OnX 1.5-2.0 INR for about 2 years, with W+ASA81, but found it streesful to play with the lower end; kept the ASA81 but moved to 2.0-3.0; after few years, started developing bleeding events; dropped off the ASA81, no more events as per the doctors in my family advise ( 12 of them), After 10 years of AVR, "once" a week i take an ASA81, but no more than that, works "for me".

 

[pellicle]

after few years, started developing bleeding events; dropped off the ASA81, no more events

if these were GI bleeding events (not say, extra bleeding from your skin) then this is a significant indicator that you may actually have a helicobacter infection.

Don't just rely on me, Google it:

Helicobacter pylori (H. pylori) is a bacterial infection that is the strongest known risk factor for gastric cancer. H. pylori is a common infection that colonizes the stomach of more than half of the world's population. ​

and

Helicobacter pylori (H. pylori) is considered the primary causative agent for most gastric ulcers, as it can damage the protective lining of the stomach by causing chronic inflammation, allowing stomach acid to erode the tissue and form open sores (ulcers) in the stomach lining; essentially, H. pylori infection is a major risk factor for developing a gastric ulcer. ​

Its very simple to test for and eradicate if present.

Best Wishes