Friday, May 25, 2007
Elaine Hylec (coumarines)
Hello:
The intent of the article is not to invoke fear, but to insist on better blood pressure control and minimize the use of concomitant aspirin. Unfortunately, only coumadin-like drugs have been shown to greatly minimize the risk of ischemic stroke. Aspirin alone will also increase the risk of intracerebral hemorrhage. Your risk of ischemic stroke with atrial fibrillation is still considerably higher than the risk of a bleed. Ischemic stroke is associated with a 24% 30-day mortality. If it were me, I would definitely stay on marcoumar. There hopefully will be newer agents in the next few years with a more predictable level of "blood thinning."
Hope this has been helpful. I would hardly consider any veterinary surgeon "simple"!!
Best wishes,
Elaine Hylek
________________________________
From: Jan Goossens [mailto:roodbont@zonnet.nl]
Sent: Tue 5/22/2007 7:42 AM
To: Hylek, Elaine
Subject: atrial fibrillation
Dear doctor Hylec
My medical doctor diagnosed atrium fibrillation 23 November 2006, and
prescribed me Marcoumar. By blood control the INR has to be between 2
and 3. It varies until now between 1,75 and 3,5.
I am a simple veterinary surgeon, 82 years old and have to use now and
than a couple of celebrex pills, when gout comes up. Moreover I use
omeprazole to keep my stomach quiet. To keep my blood pressure adequate
I use 4mg perindopril and since my atrium fibrilation 50 mg atenolol.
I had not to much troubles with my atrium fibrillation, except now and
than heart palpations.
Reading an article in Neurology 2007; 68: 116-121 by M.L. Flaherty et
al.: The increasing incidence of anticoagulant-associated intra cerebral
hemorrhage and your article in Circulation, May 2007 I think maybe it is
better to use 80 mg aspirin with or
without persantin (pirydamole) to avoid anticoagulant-associated
intra cerebral hemorrhage.
In the meantime I got a cardioversion at 18 May 2007 and my heart is
working normally again.
I would be much obliged to you, if you let me know if you can agree with
my supposition and I can discus it with my doctor.
sincerely yours Jan Goossens.
This electronic transmission may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the intended recipient, please notify me immediately as use of this information is strictly prohibited.
The intent of the article is not to invoke fear, but to insist on better blood pressure control and minimize the use of concomitant aspirin. Unfortunately, only coumadin-like drugs have been shown to greatly minimize the risk of ischemic stroke. Aspirin alone will also increase the risk of intracerebral hemorrhage. Your risk of ischemic stroke with atrial fibrillation is still considerably higher than the risk of a bleed. Ischemic stroke is associated with a 24% 30-day mortality. If it were me, I would definitely stay on marcoumar. There hopefully will be newer agents in the next few years with a more predictable level of "blood thinning."
Hope this has been helpful. I would hardly consider any veterinary surgeon "simple"!!
Best wishes,
Elaine Hylek
________________________________
From: Jan Goossens [mailto:roodbont@zonnet.nl]
Sent: Tue 5/22/2007 7:42 AM
To: Hylek, Elaine
Subject: atrial fibrillation
Dear doctor Hylec
My medical doctor diagnosed atrium fibrillation 23 November 2006, and
prescribed me Marcoumar. By blood control the INR has to be between 2
and 3. It varies until now between 1,75 and 3,5.
I am a simple veterinary surgeon, 82 years old and have to use now and
than a couple of celebrex pills, when gout comes up. Moreover I use
omeprazole to keep my stomach quiet. To keep my blood pressure adequate
I use 4mg perindopril and since my atrium fibrilation 50 mg atenolol.
I had not to much troubles with my atrium fibrillation, except now and
than heart palpations.
Reading an article in Neurology 2007; 68: 116-121 by M.L. Flaherty et
al.: The increasing incidence of anticoagulant-associated intra cerebral
hemorrhage and your article in Circulation, May 2007 I think maybe it is
better to use 80 mg aspirin with or
without persantin (pirydamole) to avoid anticoagulant-associated
intra cerebral hemorrhage.
In the meantime I got a cardioversion at 18 May 2007 and my heart is
working normally again.
I would be much obliged to you, if you let me know if you can agree with
my supposition and I can discus it with my doctor.
sincerely yours Jan Goossens.
This electronic transmission may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you are not the intended recipient, please notify me immediately as use of this information is strictly prohibited.
# posted by roodbont @ 3:37 AM 
