Medically Reviewed by Evans P. Holland, MD

Newer blood thinning drugs are easier for heart patients to regulate. McLeod Cardiologist Evans Holland, MD, describe these new medications and explained a new guideline for the use of low-dose aspirin.

Here’s a summary of Dr. Hollands remarks:

WHAT’S THE DIFFERENCE BETWEEN COUMADIN AND NEW HEART DRUGS?
Coumadin (also known as Warfarin) has been around for a long time as blood thinning medication. Unfortunately, is it also found in poisons that kills rats by over thinning their blood, causing them to bleed to death.

Coumadin has been tough to deal with, because leafy green vegetables contain vitamin K and vitamin K counteracts the Coumadin. There’s something called the International Normalized Ratio. (INR is the length of time it takes blood to clot.) INR is usually between 2 and 3. With Coumadin, INR can go way up. Antibiotics increase the INR as well. They finally developed new anticoagulant medications. The ones you most commonly hear about are Pradaxa, Eliquis and Xarelto. They’re all good drugs and work well. You take it once a day and it keeps everything pretty much level. So, you can eat leafy green vegetables with it. And there’s not as many drug interactions that Coumadin has, leaving you more options for medications for your other medical problems.

WHEN DO YOU GIVE ASPIRIN?
I usually start recommending aspiring if a person has risk factors for heart disease at an early age but no coronary heart disease yet. This is called primary prevention. But then there’s new guidelines now that are saying that Aspirin, even though it’s only an 81-milligram tablet, still has an increased risk of bleeding.

If you have a low risk for coronary artery disease, you should probably should not be on Aspirin, especially if you have an increased risk of bleeding. If you do have diabetes and you’re over 40 years of age, you should be on aspirin.

If you’re 55 to 60 years old and have low risk of bleeding, it’s probably not going to hurt you to be on aspirin.  But you should certainly check with your personal physician or cardiologist before starting.

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