Warfarin Dabigatran/Pradax — Personal Story

by Janet McTaggart

What is Atrial Fibrillation? In Atrial Fibrillation, the heart muscles in upper chambers of heart (atria) do not work correctly. The muscles are not able to force the blood out of these chambers properly. That blood that should be pumped out of the heart, but is left in the atria becomes "sluggish" or ― pools".  Blood clots can form. Those blood clots can be pumped directly up to your brain, block the artery and cause a stroke. Strokes from AF are large strokes.

MY EXPERIENCE: My mother and I went to a nearby hospital and came out being told she had atrial fibrillation. We were shocked as she had been admitted into a local hospital 6 months prior for a severe condition and was never told then she had this condition. Three to five percent of people over 65 have atrial fibrillation and most don’t know they have it!

I later found out through research that 15% of all strokes occur in people with atrial fibrillation. The likelihood of developing atrial fibrillation increases with age and affects an estimated 250,000 Canadians per year.

Our family was really worried because my father had a stroke from atrial fibrillation. So we knew how important prevention is. My mother was put on Warfarin, but going for INR blood tests, monitoring her food, and going for more doctor’s visits was very hard. Recently my mom has been on Pradax(Dabigatran). Health Canada approved Pradax (Dabigatran) for preventing stroke in Atrial Fibrillation patients. This is our family’s comparison of the benefits and risks of Warfarin and Dabigatran:         

Warfarin	Dabigatran/Pradax
Surgery—you have to stop the pills and go on the injection. If the procedure is cancelled, then you start the process again taking pills & checking for INR levels until they have a new date for procedure	Surgery – You stop use of the drug at least 24 hours prior to surgery, duration depending on what your condition is. If the procedure is cancelled, then you start taking pills
Monthly blood Tests to check INR Levels	No INR Blood Tests, Easier to use day to day
Higher risk of bleeding into the brain	Lower risk of bleeding into the brain
With other medication use, people need more blood tests with certain medications every week to monitor INR levels	Fewer medication interactions and none involving dose adjustment for stroke prevention in AF indication, only one medication contraindication
Some food restrictions with medication	No conflict with foods
No stomach problems	Stomach upset/slight risk of stomach bleeding
Taking time off work/phoning doctors office for family members	Less worry for families
Cost: Low Approved under the provincial lists for covered drugs	Cost: the cost of the drug is $3.20 per day plus dispensing fee and retail mark-up. It is approved for public reimbursement in Quebec only. It has not yet been funded by Alberta Health.

Janet McTaggart was Executive Director and is currently a volunteer of the Stroke Survivors Association of Ottawa. She is not a health professional. This article reflects Janet’s experience. People with atrial fibrillation should talk to their medical doctor about the best treatment for them.

The new Canadian Stroke Network Guidelines recommend the use of dabigatran for some patients with atrial defibrillation.

CBC health article of new blood thinner options.