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what are the pros and cons of plavix and coumadin

Resolved Question:

what are the pros and cons of plavix and coumadin?
Submitted: 5 years ago.
Category: Medical
Customer: replied 5 years ago.
1 Coumadin seems to interact with every thing . My readings for over a year fluctuate from week to week
2 wasput on it becaause of atrial fibrillation . caused by chestb infection untreated and spread to heart. I think a one off occurance.
3 i do smoke but walk 4 km per day
4 age 78. BORDERLINE DIABETIC TAKE METFORMIN 2 TABLETS PER DIEM . UNDER CONTROL.pUT ON LIPITOR RECENTLY ALTHOUGH LIPID READINGS PRETTY GOOD.
5 9YEAR SURVIVOR BARRETS EOSAPHAGUS TAKE reflux medecine pariet and domperidone
6 weight 150 lbs height 5f 10
7 Want to come off coumadin and plavix seems a reasonable alternative
Expert:  Dr.Sawhney replied 5 years ago.
Dear

The use of plavix with aspirin versus coumadin in prevention of stroke in patients with a-fib was studied in a large study published in 2006 in prestigious journal Lancet and coumadin was found to be superior to plavix plus aspirin and it was found that coumadin reduced the risk for stroke by 42% over
clopidogrel and aspirin.In fact the trial was stopped because the superiority was clearly established midway in the trial period.
Therefore current recommendation is to use plavix or plavix and aspirin only when use of coumadin is contra indicated in patients with a-fib.

See link to read the lancet article
http://www.sciencedirect.c om/science?_ob=ArticleURL&_udi=B6T1B-4K4PT7M-12&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=990a46614b252f14be6b58f774d51e4a

Inanother article the use of aspirin and plavix was found to be inferior in reducing thrombogenesis and platelet activation the process which is responsible for clot formation.This is the quote from another comment published in prestigious journal chest.
"the authors concluded that association of aspirin plus clopidogrel failed to reduce plasma indexes of thrombogenesis and platelet activation in atrial fibrillation, although some aspects of ex vivo platelet aggregation were altered. They considered that anticoagulation with warfarin may be superior to combination of aspirin plus clopidogrel as thromboprophylaxis in atrial fibrillation."

Therefore it is recommended that you stay on coumadin unless there is a contraindication in your case.

Regards

Sawhney

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Expert:  Dr.Sawhney replied 5 years ago.
Here is the link to the other article I have mentioned

http://content.onlinejacc.org/cgi/content/abstract/40/3/484?ijkey=a05ee3a92dc08886cd8d9d048474f8e4ff145f83&keytype2=tf_ipsecsha

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