Harvard Heart Letter

Balancing bleeding vs. stroke risk when you have atrial fibrillation

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Careful compliance makes management of anticoagulant and antiplatelet drugs safer.

If you have atrial fibrillation and have been prescribed an anticoagulant such as warfarin (Coumadin), there may come a time when your doctor will consider adding another type of blood thinner, called an antiplatelet agent, to your anti-clotting regimen. Examples of antiplatelet agents include aspirin, clopidogrel (Plavix), and prasugrel (Effient).

Each kind of blood thinner paralyzes a different part of the blood-clotting process. Taking them together doubles your risk of a dangerous hemorrhage. But some people need both kinds of blood thinners because they are at high risk of blood clots—which can lead to the most common kind of stroke.

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