Skip to comments.Aspirin and Warfarin Equally Effective for Most Heart Failure Patients, Study Suggests
Posted on 05/10/2012 7:39:51 PM PDT by neverdem
Neither aspirin nor warfarin is superior for preventing a combined risk of death, stroke, and cerebral hemorrhage in heart failure patients with normal heart rhythm, according to a landmark clinical trial published in the May 3, 2012, New England Journal of Medicine.
The 10-year Warfarin and Aspirin for Reduced Cardiac Ejection Fraction (WARCEF) trial is the largest double-blind comparison of these medications for heart failure, following 2,305 patients at 168 study sites in 11 countries on three continents. The research was led by clinical principal investigator Shunichi Homma, MD, of Columbia University Medical Center/NewYork-Presbyterian Hospital, and statistical principal investigator John L.P. (Seamus) Thompson, PhD, of Columbia University's Mailman School of Public Health, and supported by the National Institute for Neurological Disorders and Stroke (NIH/NINDS), part of the National Institutes of Health.
In the head-to-head comparison, the combined risk of death, stroke, and cerebral hemorrhage was 7.47% per year for patients taking the blood-thinner warfarin, also known by its brand name Coumadin, and 7.93% per year for those taking aspirin -- a difference that is not statistically significant.
Patients taking warfarin had close to half the stroke risk of those taking aspirin (0.72% vs. 1.36% per year). However, warfarin patients had more than twice the risk for major bleeding (1.80% vs. 0.87% per year). These results, the investigators say, cancel each other out. However, in patients followed four years or longer, there was evidence that warfarin may be more effective in preventing the combined outcome of death, stroke, and intracerebral hemorrhage. Follow-up analyses will further evaluate this evidence and seek to identify patients for whom one of the medications is preferred.
For patients with heart failure, a weakened heart means a greater risk for blood clots that can lead to a stroke, which can be fatal or disabling. Aspirin prevents clotting...
(Excerpt) Read more at sciencedaily.com ...
Carry the risk statistics to 3 decimal places, and then when they differ in two places point out it’s not statistically significant.
Measure with a micrometer, mark with chalk, cut with an axe???
Anyhow, aspirin sounds easier to treat with. No worrying about any interfering dietary components, i.e. Vitamin K. And a single accidental overdose is less likely to have lasting ill effects.
With an artificial heart valve warfarin is a must. Add a heart stent and you need even more warfarin and aspirin.
As for vitamin K, just watch what you eat and you are ok. I don’t worry about too much vit K.
Hey, do what the doc says, live long and prosper. This study was of folks who don’t have to worry about bionics.
Funny thing, the scary name of warfarin, which in high concentrations is also used to kill rats, has nothing to do with warfare. WARF is Wisconsin Alumni Research Foundation which is who invented it. Cheese heads.
I pop an aspirin every other day, always with food just as a precautionary measure, although I have no history of heart problems.
Walking 18 holes 4 times weekly has kept my hypertension in check, my occasional arrhythmia caused by caffeine from coffee is in check, and my resting heart rate is in low 60’s.
At my age near 70, exercise beats every medication.
Interesting enough, the Doctor who was seeing me had me take an EKG to make sure I didn't have an irregular heartbeat. Seems that can also be a cause for clots as stated above.
I would personally stick with Warfarin to keep the blood properly thinned, but that's just a personal preference from my own experiences.
In the head-to-head comparison, the combined risk of death, stroke, and cerebral hemorrhage was 7.47% per year for patients taking the blood-thinner warfarin, also known by its brand name Coumadin, and 7.93% per year for those taking aspirin -- a difference that is not statistically significant. Patients taking warfarin had close to half the stroke risk of those taking aspirin (0.72% vs. 1.36% per year). However, warfarin patients had more than twice the risk for major bleeding (1.80% vs. 0.87% per year).
The bold text is the important factor. A stroke can be minor or it can be an event that destroys you. The rate of stroke for those on aspirin was double that of those on warfarin. The rate of bleeds on warfarin was about double that of those on aspirin.
I managed warfarin patients, as a pharmacist, for over ten years. Even with good control over the years we lost some patients to stroke. We also had numerous incidents of bleeds due to warfarin. Most of these bleeds were a result of patient compliance. However, Not one of my patients died from a bleed
The point I am trying to make is that I find it somewhat dangerous that the article does not go into depth about the risks and benefits of stopping warfarin and switching to aspirin. Both drugs are very good. Both drugs should be used appropriately!!!!!!
Do what your doctor tells you to do.
***Both drugs are very good. Both drugs should be used appropriately!!!!!!***
Absolutely! I have an Omniscience mitral valve and need warfarin (coumadin). I get monitored every month.
A woman I knew had the same replacement and was on warfarin till someone (not a physician) convinced her aspirin was all she needed. She died not long after from a stroke.
Another way the two drugs are similar is in price - a bottle of Coumadin from Walmart - and a bottle of aspirin are both $1.98 each... /s