Inderpaul Birdi: Warfarin or Newer Blood Thinners?
Inderpaul Birdi, Consultant Heart Surgeon at The Keyhole Heart Clinic, shared a post on LinkedIn:
”Warfarin or newer blood thinners?
We need answers.
This study is trying to find them.
Atrial fibrillation (AF) causes an irregular heartbeat and raises the risk of blood clots and stroke, which is why many patients need a blood thinner after surgery.
For patients who already have AF, one question is still open after mitral valve repair: which blood thinner best prevents clots without raising the risk of bleeding?
- For years, the standard choice has been warfarin. It’s very effective, but it needs regular blood tests to keep the dose right.
- Newer blood thinners, called DOACs, don’t need regular blood tests to adjust the dose in the same way as warfarin, and are already used after surgery.
What we lack is a large head-to-head trial in this specific group of patients.
A UK trial called AFFECT is now testing this in 1,282 patients.
Participants are randomly allocated to a traditional blood thinner, such as warfarin, or a DOAC.
The researchers will look at clots, strokes and bleeding.
Even after decades in surgery, there are still things we don’t know for certain.
I’d much rather we test them properly than rely on habit.
Research like this is how we find the answers, and how care keeps improving for the next patient.
If you are planning mitral valve repair and already live with AF, ask your surgical or cardiology team whether this trial might be suitable for you.
If you have already had surgery, they can advise on the right blood thinner for your circumstances.”
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