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Discover everything patients should know about the blood thinner Coumadin (Warfarin). I cover the mechanism of action against vitamin K, the conditions it treats (including atrial fibrillation and deep vein thrombosis a.k.a DVT), the INR and how it should be monitored.
This video describes the role of Warfarin in managing atrial fibrillation. Also included are modern day pros and cons of still using this medication that has been available for well over 50 years.
Thank you for visiting doctor AFib, I'm Dr. Morales. In today's video segment we're going to be talking about a blood thinner that has been on the market for well over 50 years, known as Warfarin or also goes by the brand name of Coumadin.Yes, it was first advertised and marketed as a rat poison way back in the 1940s. But starting in the 1950s it began to be approved for human use as a blood thinner.Nowadays it's actually used for several purposes, including for reducing the risk of stroke for atrial fibrillation, but also for treating deep venous thrombosis, pulmonary embolism as well as an anticoagulant for mechanical heart valves.
Starting in the late 1980s and into the 1990s there were several clinical trials comparing Warfarin with aspirin for reducing the risk of stroke for atrial fibrillation.Several times Warfarin was shown to be superior for reducing the risk of stroke.In meta-analysis where they combined data from several clinical trials, it showed that Warfarin reduces the risk of stroke by about 66 percent.
However, there are a lot of nuances when it comes to managing somebody who has taken Warfarin. First of all, not everybody's dose is the same based on how individuals metabolize the medication. There's a blood test called an INR, which helps your doctor monitor your Warfarin level to find the right dosage for you.At the beginning, very frequently people will have the blood tested every week until you find the correct dosage for you.After that stage, it may be only checked about once a month
The target level on the blood test for most people is between a level between two to three in that INR blood test. However, there's been several studies that have shown that the amount of time people are actually within that recommended range can range anywhere from 50 to 70 percent of the time which shows that at least 30% of the time or even more patients are not within the recommended range of that INR level.
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