AF, Warfarin & Stroke

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As we are constantly told. If taking Warfarin, it will stop you from having a stroke. Well it doesn't. This is my story. Yes I do have AF and have already had 3 oblations. Earlier this year whilst at work I wasn't feeling very well and sat down. One of my colleagues didn't like the look of me and went to ask one of the nurses in the clinic where I work to come and have a look. When they came they immediately thought I was having a stroke. Well I couldn't talk for an instance. By the time I went to A&E everything was ok, although I didn't look very well. After the usual tests I was told it's just AF and nothing we can do go home. The only  thing was my  INR was 1.4 nothing unusual there then. In Sept last year again at work I was unwell. I thought I was having either AF or heart attack symptoms. When I got to A&E, I went into see the triage nurse. That's when I had my stroke. Someone up there was looking after me. I lost everything on my right side and my voice. Again my INR was very low 1.3. They said I was very unlucky to have a stroke whilst on Warafarin but that's not how I felt. I'm now on the road to recovery and on Apixiban. How can I trust any blood thinners now. How many others have this happened to? I have also asked the specialist about how you can monitor your INR apart from usual blood tests. I was only getting them every 3 months. I've also had them on a weekly basis, They cannot answer this one. One other point, my heart specialist from a certain London hospital was told about my stroke but there has been a deafening silence. That's the NHS for you. 

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  • Posted

    Hi GrumpyPops,

    Thanks for sharing your story.

    I am on lifelong anticoagulation after episodes of DVT'a and PE's.

    On the advice of a Consultant Haematologist, I was placed on Apixaban. I have been taking Apixaban for approaching 2 years now without any side effects.

    Apixaban is a proven method of anticoagulation, with a reduced risk of internal bleeding in comparison to Rivaroxaban.

    With regard to the issue of antidote, I do believe that one has been developed and due to be authorised by NICE. However, Apixaban does have a relatively short 'half life' - the time taken for the drug to leave the body and all UK Hospitals are briefed with regards to the management of a bleed whilst on Apixaban.

    Good luck!

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  • Posted

    I have to say I've only understood it helps prevent strokes on the basis that when in AF the blood is pooling in the heart and can cause clots if beat all over the place.   I can appreciate that your recent episode must have totally rocked your confidence.    I am currently on Apixaban having previously had warfarin and I have to say I think despite the fact I am quite unwell that the Apixiban is better for me than Warfarin was.    I was more legless on warfarin.      They put the fear of god into you about apixiban and no antidote I even wondered how I would be with a nose bleed but I have had no problems.     Just hope I don't have a nasty fall I guess!    Have had an operation recently and had to stop 48 hours before.   Endoscopy just stopped on morning.   Ablation and just stopped on morning. I've had a 2nd ablation and they plan to stop apixaban in 2 months and coming on the forum I am a bit more aware of the stroke risk but I still feel I want to see how I am when off the tablets even though of course I will be extra aware of situation if I start AF again!     Time alone will tell how it all works out.     

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  • Posted

    I have only joined this forum recently and I find your comments very interesting if slightly alarming. Let me get my background out of the way first; I am 65, living in the UK, have had a prosthetic aortic heart valve since 2005 (I think!) and thus have been on warfarin ever since (I understand that Apixiban is contra-indicated for prosthetic heart valves), my therapeutic INR range is 2.5 – 3.5, I was diagnosed with AF about 18 months ago, prescribed 240mg Slozem.

    Like others when I read that you had a stroke and your INR was 1.3 my thought was “that’s not far off the norm of 1.0”. From my minimal research I understand that someone with AF is 5 times more likely to have a stroke than someone who does not have AF and that this is reduced by two thirds by thinning the blood. So I guess my question is what is your therapeutic INR range?

    I was also perplexed that when you asked about monitoring your INR more closely they didn’t mention that you can self-monitor by using a home test machine from Roche. I realise that you had asked about ways of monitoring INR other than using blood test so maybe that is why they didn’t mention it. Also since INR is a measure of the prothrombin time which measures how quickly blood will clot it means that the blood has to be tested, or measured if you like, somehow.

    I am an IT consultant and often work at locations away from home so to have a blood test at the clinic or hospital every so often means losing a day’s fees; the cost of a test machine was a few hundred pounds so it seemed like a good option to me. Actually it was my cardiac consultant surgeon that suggested it to me. I just measure my INR, email my GP surgery and they respond with a dosage and when to next do a test. If I feel a bit twitchy that my INR might be too low or high then I do a test and see. It works for me.

    One last thing, I don’t understand what you mean by being “…. more legless on warfarin.” what unwanted effect did warfarin have on you, did it make you unsteady on your feet? or am I being a bit slow on the uptake here?

    I hope the above has been of some interest to you.

    From my perspective when I learned more about what AF is and it’s effects, i.e. increased chance of stroke, I was a bit perturbed, I still am if I’m honest with myself. Still, onward and upward!



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  • Posted

    I would not be happy with your medics if they're happy with INR of 1.3/1.4/. As others have said Warfarin INR should be in 2.0/3.0 range to be effective. against stroke.

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  • Posted

    Your INR should read between 2,0 and 3.0.

    I have been on Wafarin by my choice since the drug has been on the market since the 1950's.Now i have 6 years experiene of being on the drug.

    it does require diascipline and good haboits  to eat the coreect foods and go for INR testing onve a month.

    Your advice ill serves those of us who read the warnings on these newer drugs and practice caution.

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