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Rule Identifies Women Who Have Low Risk Of Vein Blood Clot Recurrence

Date:

Ottawa Hospital Research Institute

Summary:

Medical researchers have developed and validated a rule that could let half of women with unexplained vein blood clots stop taking blood thinners for life.

A Canadian-led research group has developed and validated a rule that could let half of women with unexplained vein blood clots stop taking blood thinners for life. These findings were published in The BMJ.

Over 1.5 million Canadians will experience a vein blood clot their lifetime, known as venous thrombosis. If part of the clot breaks off and travels to the lungs, it can be fatal. Half of these blood clots happen for no apparent reason, and are known as unexplained or unprovoked clots.

Once an unprovoked vein clot is treated, guidelines recommend that patients take blood thinners for the rest of their lives. If they do not, their risk of having a second clot is 30 to 40 percent in the next 10 years. Taking life-long blood thinners virtually eliminates this risk, but comes at a cost of a 1.2 percent chance of major bleeding per year.

The HERDOO2 rule, so named to help physicians remember the criteria, was developed by an international team led by Dr. Rodger and published in 2008. According to the rule, if a woman has one or none of the following risk factors she is at low risk for having another blood clot:

Discoloration, redness or swelling in either leg High levels of a clotting marker in the blood Body mass index of 30 kg/m2 or more Older than age 65

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Side Effects And What To Look Out For

Tip: You can find a full list of side effects in the patient leaflet that comes with your medication.

Like all medications, blood-thinning medications can cause side effects, which may be mild or more serious.

Serious side-effects

• If you have any stroke symptoms always call 999 immediately.
• If you have blood in your wee, poo or vomit, severe bruising, chest pain, wheezing or difficulty breathing, contact your GP immediately or go to your nearest accident and emergency department.

Other side-effects

These vary between types of medication, but the most common include:

Dont stop taking your medication if youre having side effects, as this can increase your risk of a stroke.

Do contact your GP, pharmacist or call 111 to get help and advice.

You can report side effects using the Yellow Card scheme run by the Medicines and Healthcare products Regulatory Authority on their webpage.

Dental and medical treatment

Before any dental treatment or surgical procedure, tell your dentist or doctor you are taking blood-thinning medication. You might need to stop taking it before the procedure, but only with medical advice. You may need an alternative medication such as heparin for a short time.

If you need an emergency operation while taking warfarin, you may need treatment to reverse the effects of warfarin.

You should be given an anticoagulant alert card to carry in case you need emergency medical treatment.

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Benefits And Risks Of Blood

Benefits

Taking blood-thinning medication is often one of the main ways you can reduce your risk of a stroke if you have had a stroke or TIA, or have a heart condition. By reducing the risk of clots forming, they give you a much greater chance of recovering and staying healthy after a stroke.

Risks

Blood-thinning medications carry an increased risk of bleeding. This can be mild, such as small cuts or injuries taking slightly longer than usual to heal. There is also a small chance of more serious bleeding, such as bleeding in or around the brain .

Whats right for you?

You will only be offered medication if the benefits to your health outweigh the risks. You are carefully assessed to work out which treatment is right for you. This depends on:

• The type of stroke you had.
• What caused the stroke.
• Other health conditions you have.
• Other medications youre on.

Doctors discuss your options with you, and make sure you know how to take the medications. Youll be monitored when you start taking medication. Your dose or the type of medication may be changed, and you might be given a combination of medications.

Keep Your Md Updated On Lifestyle Changes

Your lifestyle will play a role in your doctor’s decision to prescribe blood thinners or not. Most people who take a blood thinner on an empty stomach at the same time every day and follow a relatively stable diet will do fine, Dr. Garcia says. But he also recommends drinking alcohol only in moderation. Binge drinking could cause drastic fluctuations in how long it takes your blood to clot, and could also lead to falls or accidents, which could increase the risk of blood thinner side effects, like excessive bleeding. Elderly people who live alone are at increased risk for falling and injuring themselves, so blood thinners may not be right for them. Instead, Garcia says, doctors may recommend an aspirin.

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Food And Your Blood Thinner

If your doctor has prescribed warfarin, the foods you eat can affect how well your blood thinner works for you. High amounts of vitamin K can work against warfarin. Other blood thinners are not affected by vitamin K. Ask your doctor if your diet can affect how well your blood thinner works.

For a list of foods that contain vitamin K, go to www.usda.gov and search for vitamin K.

If you are taking a blood thinner, you should avoid drinking alcohol.

Managing Your Health Alongside The Cardiac Experts

Sal is a guy who never complains, Purvis said. After years and years of taking care of him, I can see it when hes doing well, and when he isnt.

In 2017, echocardiography showed Sals heart was weakening, prompting a coronary angiogram, which showed a significant blockage in the main coronary artery that supplies the heart muscle with blood. Purvis placed a stent within the artery to open the blockage. It worked, but it added a daily, lifelong dose of Aspirin to his regimen of pills, as well as another blood thinner, Plavix, for the next year.

And though there were few alternatives beyond medication for many of Sals heart issues, he did have an option that could help him get off the needed blood thinner for his AFib.

Over the past few years, Sal talked about wanting to come off the Warfarin because of the hassle of the bleeding and bruising, Purvis said.

The bruising seems to have gotten worse over the years, Sal added.

I would get black and blue bad. It looked like someone beat the heck out of me, Sal said. I had a habit of bonking into things. It relaxes your mind realizing youll get off blood thinners.

Sal and Purvis both agreed that he was a good candidate for The Watchman, which the U.S. Food and Drug Administration approved in March of 2015. UCHealth performs over 100 Watchman procedures annually in northern Colorado.

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Web. Web. May 30, 2022 · Stopping bloodthinners can increase your risk for blood clots, due to the underlying risk factor for which your bloodthinner was originally prescribed. Many times, these bleeding and clotting risks can be complicated for you to understand, and difficult for your healthcare providers to manage.. Aug 11, 2019 · Excessive bleeding is the mostcommon reaction.Possible side effects of bloodthinners. heavy periods. bloody or discolored urine or feces. nosebleeds. bleeding gums. prolonged bleeding from a cut. Do bloodthinners make you cold and tired? A bloodthinner works by slowing or impairing the bloods ability to clot, Dr. Andersen said, and …. Among the most commonly used blood-thinning medications are the following: Aspirin Coumadin /Warfarin Heparin Lovenox Plavix The choice of a bloodthinner is typically made by the surgeon, who is most likely to know how much bleeding is expected during a particular surgery.

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Web. Bloodthinner rules or reasons for use are often filled with many exceptions related to your medical history. You should never start or stop taking bloodthinners before talking to your doctor. Below we will discuss what bloodthinners are and explain the mostcommonbloodthinners used in everyday medical practice..

Web.

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What Else Do I Need To Know About Blood Thinners

• Tell all of your healthcare providers and dentist that you take a blood thinner. This will help them plan for procedures and surgeries. It will also prevent them from giving you medicine that may interact with your blood thinner.
• You should not take antiplatelet medicine if you have liver or kidney disease, a peptic ulcer, or gastrointestinal disease. You should also not take this medicine if you have a bleeding disorder, uncontrolled asthma, or uncontrolled high blood pressure. These conditions may increase your risk for bleeding.
• Take anticoagulants exactly as prescribed. Do not double up on a dose if you have missed a dose. Some anticoagulants should be taken at the same time every day.
• Keep appointments for blood tests if you are taking warfarin. Blood tests will help your healthcare provider make changes to your dose of anticoagulants so that they work correctly. The blood test will measure the amount of time it takes for your blood to clot. This is called the international normalized ratio . If your INR is too high, you may be at an increased risk for bleeding. If your INR is too low, you may be at an increased risk for blood clots. Your healthcare provider may change the dose of your anticoagulant medicine depending on the results of your blood test.

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Things To Avoid When Taking Blood Thinners

Blood thinners can prevent blood clots in the body. You may know clots as scabs: the itchy covering your body forms over cuts and scrapes. Clots can form internally and externally. Inside your body, clots can block blood flow to essential organs including the heart, lungs and brain. This means they can do serious damage if left untreated.

Are Anticoagulants and Blood Thinners the Same?

Blood clots can cause a number of severe health problems, including:

• Artery blockage

Physicians often prescribe blood thinners to patients with risk factors for blood clots. These risk factors include heart rhythm issues and recent leg or foot surgery.

As with any medication it’s important to understand how to use blood thinners safely. All drugs – over-the-counter or prescribed – come with a clear label. The label explains how to correctly use the drug and how to avoid potentially harmful interactions. These interactions can come from food or other medications.

Despite the drug label, it can still be hard to understand how to minimize harmful reactions to blood thinners. To help consumers use blood thinners correctly, we’ve compiled this list of things to avoid while taking blood thinners.

Getting Off Blood Thinners For Good

Sal Delprete is a Yankees fan through and through. His childhood was filled with 75-cent visits to Yankee games, and in his fathers last year of life, the family attended all 81 home games from box seats his fathers dying wish.

Everything Sal knew of baseball, he learned from his father.

At 13, Sal caught a ball from one of baseballs most feared hitters, Mickey Mantle, which Mantle then signed. And now, even as a Colorado resident, Sals devotion to his hometown team is immutable.

One of Sals favorite doctors, UCHealth interventional cardiologist Dr. Matthew Purvis, is fully aware of Sals East Coast allegiance. The two banter about baseball during appointments or when they pass in the hallways at UCHealths northern Colorado facilities, where both work.

Purvis is a fourth-generation Coloradan, so not surprisingly, hes loyal to his hometown team, the Colorado Rockies. These men love to rib each other about which baseball team is better its all in good fun.

But, they actually agreed wholeheartedly on a life and death matter. Sal could benefit mentally and physically from a medical device, and the expert cardiology team at UCHealth were the perfect providers to implant it.

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Stay Safe While Taking Your Blood Thinner

You can be bleeding but not see any blood. For example, if you fall and hit your head, bleeding can occur inside your skull. Or, if you hurt your arm during a fall and then notice a large purple bruise, this means you are bleeding under your skin.

Because you are taking a blood thinner, you should try not to hurt yourself and cause bleeding. You need to be careful when you use knives, scissors, razors, or any sharp object that can make you bleed.

You also need to avoid activities and sports that could cause injury. Swimming and walking are safe activities. If you would like to start a new activity that will increase the amount of exercise you get every day, talk to your doctor.

You can still do many things that you enjoy. If you like to work in the yard, you still can. Just be sure to wear sturdy shoes and gloves to protect yourself. If you like to ride your bike, be sure you wear a helmet.

To prevent injury indoors:

Lifestyle Affects Heart Issues

Although family history is a large factor in heart disease, Sal is the only one in his family to have struggled with hypertension, cardiomyopathy , and AFib.

His high blood pressure first started after he enlisted in the Navy in 1969, so he wonders if stress had something to do with it. Although the stress never subsided as he aged, he was able to manage his hypertension with medication.

After serving in the military, Sal spent 20 years as a customer service specialist for the United States Postal Service. He worked 14-hour days as the troubleshooter, handling complaints, standing up for workers and straightening out issues.

Meanwhile, his first wife, Margaret, fought cancer seven times in total, including three different occurrences of breast cancer. Her medications were expensive, so Sal skipped buying necessary blood pressure medications. The couple moved to Colorado after Sal retired in 2007. It was then that he started seeing Purvis.

At that time, Sal had cardiomyopathy but no blockages so we put him on medication to treat and improve his AFib, Purvis said.

Sadly, Sal lost his wife to cancer in 2010.

He spent a lot of time at Poudre Valley Hospital while Margaret was getting treatments. And hed see Purvis in passing, stopping for some baseball banter that would lighten every visit. Sal later applied for a laundry position at the hospital and later joined the EVS team. And in 2011, he married Debbie.

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