Half a million people in Germany are taking long-term anti-coagulant medicines and another 350, 000 are in need of limited time. The reason is that they are at increased risk of clots forming in their bodies and, when flushed with the bloodstream, cause strokes or vascular occlusions in other organs. "Precisely adjusted anticoagulation protects these patients from such thromboembolisms and, very often, from life-threatening complications", emphasizes Prof. Dr. med. med. Hans-Jürgen Becker, CEO of the German Heart Foundation.
Risk factors for strokes
Cardiac arrhythmia, especially in old age, is one of the major risk factors for stroke. Significantly increased the risk of thromboembolism even in a severe narrowing of the mitral valve in the heart, after the onset of a new heart valve, in certain disorders of blood clotting or if in the past already once a thromboembolism occurred. Anyone who has received a mechanical heart valve needs anticoagulant drugs such as Marcumar® or Falithrom® for life, but if they use a biological valve, they will need it for three months after surgery.
Objective: Optimal embolism protection with minimal risk of bleeding
Effective and safe, the anticoagulation is only when it is precisely adjusted. Because every under-dose of anticoagulant drugs carries the risk that the protection against strokes or embolisms is not sufficient, overdosing on the other hand makes the blood so fluid that it easily bleeds. In order to obtain optimal protection against clot formation with minimum risk of bleeding, the blood coagulation is set in the so-called therapeutic range.
The INR (International Normalized Ratio) value is used to define this area individually for the individual patient. In order to prevent the anticoagulation from escalating up or down, it is recommended to monitor the INR value regularly or to have it measured once a week, but at least every 14 days by the doctor. Often, only three to four weeks are controlled in Germany - a period of time that must be considered too low for optimal coagulation control.
Quick value is "out"
Previously, the so-called Quick value was determined to control the inhibition of coagulation. This has proved to be insecure for the patients, since the measurement results of different laboratories are often not comparable. "Unfortunately, there are still a few doctors' practices and clinics in Germany that work with the Quick value, " criticized Prof. Becker. Patients taking Marcumar® or similar medicines should ensure that their anticoagulant is measured only by INR.
A major advance in coagulation control is also the ability to self-assess the INR after appropriate training - with a drop of blood from the fingertip and a small device that operates similarly to a blood glucose meter. "Self-measurement of the INR value, " says Prof. Becker, "allows for better, safer, more flexible and more independent control of anticoagulant activity, helping to increase the efficacy of anticoagulant medication and reduce the risk of complications. "
A list of training centers for self-determination of anticoagulation and a special anticoagulation card are available free of charge from: Deutsche Herzstiftung, Vogtstr. 50, 60322 Frankfurt am Main.