Cardiologists No Longer Recommend Warfarin for Most Afib Patients

Warfarin is a commonly-prescribed anti-clotting drug—often under the brand name Coumadin—but the frequency by which doctors prescribe it could change in the coming weeks.  That is because health experts are no longer recommending warfarin as a potential treatment of atrial fibrillation, in most cases, as described in new guidelines set this week by the American College of Cardiology and the American Heart Association.

Instead of this drug, health officials are now encouraging doctors and patients should investigate drugs known as “novel oral anticoagulants,” or “NOACs”.  These drugs have been developed and approved by the United States Food and Drug Administration over the past ten years or so.   

Also known simply as “Afib,” atrial fibrillation affects somewhere between 3 and 6 million Americans every year.  As a matter of fact, the United States Centers for Disease Control and Prevention say that approximately 2 percent of people under the age of 65 and nearly 10 percent of those over the age of 65 experience symptoms of this condition, annually.  Those numbers make Afib the most common type of heart arrhythmia. 

Indeed, lead study author Dr. Craig January comments, “It becomes an even bigger problem as people age into their 70s and 80s.” Noting that atrial fibrillation recommendations changed in 2014 and then again recently, in 2019, the University of Wisconsin cardiologist goes on to say, “The numbers of people affected by Afib will go up a great deal in our society as the population of baby boomers age.” 

That is partially why atrial fibrillation guidelines have shifted again. Health officials now encourage starting anticoagulant medications at lower stages of disease progression.  Also, they focus on making appropriate lifestyle changes that can reduce risk, like weight reduction. 

The most recognizable symptom of atrial fibrillation is a flutter in the chest. Essentially, it feels like the heart is quivering instead of beating in a steady rhythm.  Some also comment that it feels like their heart is flip-flopping like a fish out of water; others describe it as the heart skipping a beat and then racing to catch up with it. 

More importantly, though, these initial symptoms result in erratic heartbeat, which can cause blood pools, and even clots, to form. When the heart resumes normal beating, these clots can be distributed into the bloodstream, which can cause other problems. In fact, Afib is actually the cause of 20 percent of stroke cases.