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Is it safe to stop blood thinners for a few days for a surgery?

4 answers | Last updated: Jan 25, 2014
Jagdish asked...
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Carolyn Strimike, N.P. and Margie Latrella, N.P. are cardiac nurse practitioners specializing in the prevention of heart disease and stroke. They have over 40...
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The anti-platelet medications aspirin and Plavix are VERY IMPORTANT to take after having a stent placed in one of the heart arteries. These medications are commonly called blood thinners but See also:
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are actually anti-platelet meds which mean they also prevent blood clots from forming by preventing platelets (which are a type of blood cell) from clumping together - which is the intial process of a blood clot. I agree completely with your cardiologist - this is the healthcare provider who should be making the decision when it is okay to temporary stop the "blood thinners" before surgery. It takes time for the metal on the heart stent to grow tissue over it, so the metal is exposed to the blood and that is why you need the anti-platelet or "blood thinning" medications. If you were to stop the medications too early, before the tissue is covering the metal of the stent - blood clots can form. These blood clots could totally block off the blood vessel in the heart and lead to a heart attack. I worked in the heart catheterization lab for many years and unfortunately saw many patients come in with heart attacks because they stopped their Aspirin and/or Plavix too early or temporarily before elective surgery. You should talk to your cardiologist and find out when he/she feels it would be safe to temporarily stop your Aspirin and Plavix, it depends on the type of stent you received and if it was a "medicated stent" (which could require Aspirin and Plavix therapy even longer).

UPDATE:

Uncle Joe, We definitely agree that each person needs to discuss their individual situation with their healthcare provider.

Just to clarify INR monitoring is necessary with warfarin/coumadin ("true" anticoagulants) Plavix and Aspirin, do not affect the same pathway they are antiplatelet medications and INR monitoring is not helpful.

 

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uncle joe answered...

Depending on the surgical intervention sometimes stopping AND MONITORING the I N R to reach desired levels for the day of the surgery is sufficient for milder cases. Re-starting is also decided with a dose and monitored till INR levels reached. For other cases bridging with heparin injections daily while stopping warfarin is the protection. Each case need to be evaluated intelligently and thoroughly and maximum protection available incase reversal of severe bleeding became necessary. I would urge everyone well before surgery to ask questions which was prepared, and make sure the answer is clear and understood to give informed consent. I am concerned that the professional advice given here is missisng this information. Much competing and contradictory professional opinions litter the web. We need to be vigilant protecting our health and safety as well as advocating for those needing it but can not do it themselves. Trusting on blind faith could be risky. Very risky!

Be well!

 

sheschab answered...

My brother was told to stop his meds for 7 days before a colonostomy. He hadn't had any heart issues in 3 1/2 years (stints and bi-pass). On the 4th day off his meds, he died from a heart attack at 50 years old. I can't prove that is the reason-it's been less than 2 weeks since his death-but it is definitely something to think about.

 

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uncle joe answered...

DEAR CAROLYN,

I haven't investigated the mentioned medications and their effect on blood clotting, various doses etc.

I expect the cardiologist to be up to date with the safety issues so he/she is responsible advising the patient accordingly.

I speculate an assay could demonstrate the level of saturation and some tapering off achieved from 5 days from the date of surgery if that level is deemed safe for the day.

I know for a fact that with Warfarin the small molecular weight Heparin is used daily the dose determined by body size and the in injections maintained to the very day of surgery while INR monitored daily and tapered off to safe level. After the procedures warfarin reintroduced again monitoring the INR reaching desired level all the while heparin is given the same time.

Bed well!

uncle joe.

 

 
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