Aspirin for Stroke

Aspirin for Stroke or Warfarin for Stroke?



According to the latest research, the WARCEF (Warfarin and Aspirin for Reduced Cardiac Ejection Fraction) trial, neither aspirin or warfarin is superior for preventing a combined risk of death, stroke, and cerebral hemorrhage in heart failure patients with normal heart rhythm. This is NOT for patients with atrial fibrillation, just patients with reduced ejection fraction.

Aspirin or warfarin



Patients with heart failure are at risk  for death and stroke due to thromboembolic events or a blood thrombosis.

What is a Blood Thrombosis?

A thromboembolic event is a blood thrombosis is the formation of a clot (thrombus) in a blood vessel that breaks loose and is carried by the blood stream to plug another vessel resulting in a stroke, heart attack or even a pulmonary embolism (clot to lungs).


In the WARCEF Trial,  the head-to-head comparison or warfarin and aspirin was not statistically significant when accounted for the combined  risk of death, stroke, and cerebral hemorrhage.


When looking at stroke risk only, those patients taking warfarin had close to half the stroke risk of those taking aspirin. However, warfarin patients had twice the risk of major bleeding. Long term use of warfarin (4+ years) is however more effective in preventing the combined outcome of death, stroke and intracerebral hemorrhage. More follow analysis is ongoing.


It is important to discuss with your doctors the best course of treatment when you have or at risk of heart failure with normal ECG rhythm. Warfarin requires a prescription and regular blood tests and aspirin can be bought over the counter. The biggest key decision to discuss with your doctors is to accept the increased risk of stroke with aspirin or increase risk of GI (gastrointestinal) bleeding with warfarin.


To your heart health success,
Diamond Fernandes

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