Recent research into how your blood thinner affects your brain and the risks of dementia has indicated that patients with Atrial Fibrillation who maintain adequate blood levels of Coumadin (warfarin) have the lowest risk of dementia later in life.
We know that the irregular heart rhythm, Atrial Fibrillation, increases the risk of dementia.
However, by monitoring your blood levels of this blood thinner, and maintaining them within the optimal range, that risk is greatly reduced.
If you’ve been prescribed this or other blood thinners, develop a plan with your doctor to monitor how well it’s working.
➡ In addition, if you have Atrial Fibrillation and are taking Coumadin, (also known as Jantoven), maintaining your blood levels in the ideal range may help you avoid a stroke, one of the major risks of having atrial fibrillation.
The link between Atrial Fibrillation and Alzheimer’s disease, the most common form of dementia, has been known for a few years, according to T. Jared Bunch, MD, Cardiologist and Medical Director for Cardiac Electrophysiology at Intermountain Heart Institute.
But his team has found that maintaining target blood levels of your anticoagulant can help preserve cognitive functioning.
Here’s his conclusion: ”What we found was, there was a very significant correlation with the lack of Coumadin effectiveness, or lower percent of times in the therapeutic range, and the risk of dementia.”
- The study included 2,600 patients.
- Their average age was 74.
- None had dementia at the start of the study.
However, by the end of the five-year follow up, 109 patients had been told by a neurologist that they had dementia.
Following up on that, Dr. Bunch’s team looked to see if there was any link between two things —
➡ How often these patients with atrial fibrillation had their Coumadin (warfarin) within the ideal target range
➡ And whether or not they developed dementia.
**A low INR means your blood is ‘not thin enough’ or coagulates too easily and puts you at risk of developing a blood clot.
**A high INR result means your blood coagulates too slowly and you risk bleeding.
While this research can’t prove cause and effect, the researchers did find a strong correlation.
➡ Those who had an INR in the target range (2 to 3) more than 75% of the time — were four times less likely to develop dementia than those in the target range only 26-50% of the time.
Dr. Bunch followed the patients for five years and then did an estimate or projection for an entire decade.
He states: ”From the data, the projected risk of dementia with very well-controlled Coumadin was less than 3% at 10 years.”
Warfarin Levels & Dementia: A Second Opinion
The new findings definitely suggest that keeping warfarin within the ideal range provides dementia protection as well as stroke protection, according to Luigi Di Biase M.D., senior researcher at the Texas Cardiac Arrhythmia Institute, who reviewed the findings.
“It makes absolute sense,” he says. However, he cautions that it can be difficult for patients with atrial fibrillation to stay in that optimal range.
This is because warfarin can interact with other drugs. In addition, certain foods and drinks (greens, alcohol) can affect how well warfarin works.
What we don’t yet know, however, is if these findings of dementia will apply to the newer generation of blood thinners (i.e. Pradaxa, Xarelto, Eliquis) whose major selling point is that patients won’t be required blood testing.
There is currently no blood test commercially available to measure the new drugs’ effectiveness in the blood.
➡ If you have been prescribed one of the newer medicines, make sure your physician monitors your kidney function with a blood test at least twice a year.
Until more research is in, you can take steps to improve your health, no matter which drug you’re taking for atrial fibrillation.
➡ If you’re just starting on an anticoagulant, develop a monitoring plan with your physician, and stick to it.
➡ If your blood level of the anticoagulant is not ideal at least 75% of the time, discuss the possibility of switching to another medication.
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