I am 59; had St. Jude Mitral Valve Replacement 20 years ago following Acute Bacterial Endocarditis (had pre-existing Mitral Valve Prolapse, exact etiology of this incident never identified). Have been on Coumadin, well-controlled, with INR 2.5-3.5 throughout, with no significant incidents.
Normal Sinus Rhythm. Normal Echo and Left Atrial dimensions. Mild HBP, well controlled, Cholesterol 166 with Lipitor 10mg QD.
Extremely active physically (competitive volleyball, 2 to 6 hours/week for the last 20 years, generally with men half my age).
My question concerns the pros and cons of adding a baby aspirin to the Coumadin therapy, mainly with respect to stroke prevention. My level of physical activity does increase bleeding risks somewhat in terms of musculoskeletal injury, and I am aware of the risk for G.I. bleed being increased with Aspirin as well.
I am not your "average" Prosthetic Valve patient - no atrial fib, normal left atrial size, high level of fitness and activity, and wonder if the added benefit documented in some studies through the addition of aspirin applies to me, or if I am in a different clinical population, where the added risk of bleeding really wouldn't be offset by lower risk of stroke.
Have discussed with my Cardiologist; he recommends the Aspirin, perhaps going to every other day, but acknowldges that there is not a clear-cut answer.
Here for knowledgeable "second" opinions.