Harvard Heart Letter

Balancing bleeding vs. stroke risk when you have atrial fibrillation

People with atrial fibrillation who are at risk of stroke should be taking a kind of anti-clotting drug called an anticoagulant: warfarin (Coumadin), for example. If stroke risk gets even higher, such as after a heart attack or unstable angina, your doctor may prescribe another kind of anti-clotting drug called an antiplatelet agent. These drugs include aspirin, clopidogrel (Plavix), and prasugrel (Effient). This combination therapy is very good at preventing stroke, but it increases the risk of dangerous bleeding. People taking anticoagulant-antiplatelet combinations can lower this risk by avoiding big doses of vitamin E, drinking little or no alcohol, avoiding NSAID painkillers, and avoiding supplements and herbs that increase bleeding.
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