Warfarin vs asprin+clopidogrel

[nspower]

My cardiologist is pressing me to shift from asprin+clopidogrel to warfarin. He says I have chances of getting a clot in damaged section of heart (anterior) and warfarin is more effective. For last two yesrs I am on asprin+clopidogrel. My EF is 35% due to MI in 2007.

Anyone who has experience and/or information on above, please advise.

Thanks

[kenkeith]

Nspower, I almost always hesitate to discuss an individual's medication for lack of knowledge regarding biochemical interaction with the human system and no information regarding an individual's health history, etc.. The doctor should have the necessary information to make the right decision.

I do know there are different anti-platelet mechanisms with each medication you are referring as well which mechanism of action is perferred for a specific malady and the interaction with other medicaion.

My experience is with dual therapy (aspirin and plavix) and the last I heard that therapy is a appropriate post DES implant.  It seems plavix helps reduce the risk for clots at implant site, and after a year the risk of clots is less than the risk of excessive bleeding with plavix. After a year discontinued plavix and remain on a baby aspirin.  Several months ago after some dental work there was excessive bleeding for hours on a baby aspirin...so I'm not cool with large doses of anti-platelet meds.

Warfarin can cause very serious (possibly fatal) bleeding. The risk for excessive bleeding is more likely to occur when you first start taking this medication and/or when you are taking too much warfarin. To help decrease the  risk for bleeding, you will be closely monitored with lab INR test to make sure you are not taking too much warfarin.

You have an EF below 35% and there are medical opinions that warifarin is a better option for anti-platelets for that classification of heart disorders.  If my memory serves I answered the same question on a prior post...did you miss it?  Take care.

[nspower]

Thanks Kenkeith.
I have been on dual anticoagulant (asprin+clopidogres(also called pelvix)) theraphy for 2.5 years post MI with EF 35%. After 2.5 years my cardiologist suggests me to change to warfarin + asprin theraphy. I am scared of warfarin due to its side effects and risks.

What are my risks if I continue with my currrent asprin+clopidogrel dual anticoagulant theraphy?

Shall appreciate advice or sharing your experience with these drugs or necessity of changing over from one drug to another?.

[kenkeith]

From memory warifin needs to be carefully monitored (weekly) to stay within a INR range.  Warfarin helps by thinning the blood but it can be a tricky drug to take, because it also increases the risk of brain hemorrhage, so patients must be carefully monitored when taking it.

"Warfarin is linked to the most emergency hospital admissions for adverse drug effects.  In one of the first, and largest, studies of its kind, Kaiser Permanente and  Massachusetts General Hospital researchers set out the risks and benefits of warfarin".

[nspower]

Thanks.
Anything on the risk factors associated with warfarin?

[kenkeith]

Warifin seems to be the medication of choice for patients with an EF below 35%.  There has been a study (warcef trial) that evaluated warfarin vs. aspirin.