FAQ Update: For stroke prevention—warfarin (Coumadin), an NOAC or aspirin?
We’ve updated our answer to the Frequently-Asked-Question (FAQ):
“For A-Fib patients, which is better to prevent an A-Fib-related stroke—warfarin (Coumadin), a NOAC, or aspirin?”
For decades, people more at risk for A-Fib-related stroke have been on warfarin (Coumadin). In the last few years, many of these patients have switched to the newer NOACs. A-Fib patients with low or no risk factors for stroke are often put on aspirin, or nothing at all.
Differences with the Same Goal
Aspirin is an antiplatelet drug that decreases the stickiness of circulating platelets (small blood cells that start the normal clotting process), so that they adhere to each other less and are less likely to form blood clots. (Cost: dirt cheap.)
Warfarin (brand name Coumadin) is an anticoagulant that works by slowing the production of blood clotting proteins made in the liver. Warfarin is highly effective, reducing the annual risk of stroke by approximately two thirds, but does require periodic lab tests to maintain the proper therapeutic level. (Cost: dirt cheap + lab tests.)
NOACs stands for Novel Oral AntiCoagulants. NOACs are alternatives for vitamin K antagonists (e.g., Warfarin). NOACs don’t require periodic blood testing as with warfarin. The clinical trials indicate NOACs work as well as warfarin. (Cost: Extremely expensive.)
—Continue reading—for the rest of our answer along with a few takeawys.