Question: Why do some patients have to take Coumadin after a heart attack and others do not?
Answer: Coumadin is a blood thinner, a very potent blood thinner that is quite useful to reduce blood clots. Now, not everybody after a heart attack is going to be placed on coumadin; typically these days, the only patients that we put on coumadin after a heart attack are ones that have arrhythmias or abnormal heart rhythms like atrial fibrillation, where the upper chambers of the heart are beating irregularly and that predisposes to blood clot formation that can lead to things like a stroke.
So in that sort of circumstance, coumadin can really be quite useful, though it does carry a risk of bleeding like all blood thinners do. Other people who have really big heart attacks, where a large part of the heart muscle is not moving and perhaps a blood clot has formed within the heart itself, are people who would end up taking coumadin. So that's not everybody that has a heart attack, but rather, just a subset of people that have heart attacks.
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