EP28: Unexpected Positive Effects On Anticoagulation

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Episode Summary Dr. Warwick Bishop, a practicing cardiologist and author, discusses anticoagulant medications used to treat atrial fibrillation. While these blood thinners are primarily prescribed to reduce stroke risk by preventing clot formation in the heart, Dr. Bishop explores some unexpected positive side effects that patients and doctors should be aware of beyond their primary cardiovascular benefits. Key Takeaways: Anticoagulants like warfarin and NOACs (non-vitamin K oral anticoagulants) are prescribed for atrial fibrillation to reduce stroke risk by preventing clots in the left atrial appendage of the heart. Blood thinners carry known risks including increased bleeding, particularly hemorrhagic stroke and gastrointestinal bleeding from existing lesions. Anticoagulants provide a secondary benefit for patients traveling long distances by also preventing deep vein thrombosis (blood clots in the legs) and pulmonary embolism. Increased bleeding from anticoagulants can paradoxically lead to earlier detection of bowel cancer by making fecal occult blood tests more likely to be positive when early tumors are present. Dr. Bishop has observed patients in his own practice having bowel cancer detected early due to positive fecal occult blood tests while on anticoagulants. When starting anticoagulation therapy, patients should consult with their GP about whether they are due for fecal occult blood screening to take advantage of this detection benefit. There is a potential future application of combining short-term anticoagulant therapy with routine fecal occult blood testing to increase screening sensitivity, though this remains untested.