Heart Health

Ask the doctors: Is it okay to discontinue warfarin?

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Q.I recently developed atrial fibrillation, and I wonder whether I need to take an anticoagulant. I am 81 years old, active, and don't really notice when I am in atrial fibrillation. I was taking my pulse every now and then and found it to be irregular. My doctor said I was going back and forth between a normal heart rhythm and atrial fibrillation. I am in normal (sinus) rhythm now, but he says I should be on warfarin because I have high blood pressure. What do you think?

In this scoring system, the fewer points you get, the better. Your history of hypertension and your age give you a CHADS2 score of 2, which implies a stroke risk of 3%–5%. For people with this risk and higher, we recommend warfarin therapy. For people with a CHADS2 score of 1, aspirin and warfarin are both reasonable options. For a CHADS 2 score of 0, no treatment or aspirin alone is reasonable.

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