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Asked by James Esenwein, Iraq
My father, 59, has a heart arrhythmia. For the past few years it has been treated with blood thinners (Coumadin) and a pacemaker. After these procedures were unsuccessful he went to the Cleveland Clinic and had a heart ablation performed. He recently (October 2008) has been diagnosed with MDS. From my understanding MDS is the underformation of red blood cells that do not develop into full red blood cells. Are there any studies or have there been any studies to connect blood thinners to MDS? He currently is undergoing chemotherapy for the MDS, but also has to go back onto the Coumadin to have another heart ablation performed. He basically has to choose which disease he has to fight first. Any help in this matter would be appreciated.
Thanks James Esenwein, Major
USAF -- deployed
Conditions Expert
Dr. Otis Brawley
Chief Medical Officer,
American Cancer Society
Dear James:
Having been deployed myself, I know how difficult it is to look after a sick family member far away from you. Your dad's illnesses are most likely totally separate and unrelated.
It is common for people with certain abnormal heartbeats, especially atrial fibulation, to be treated with anticoagulant drugs to prevent blood clots from forming in the abnormally beating heart. When these clots form in the heart they can leave the heart and cause strokes or damage to the kidneys or bowel. The most commonly used anticoagulant or anti-clot drugs are forms of heparin, which are given intravenously or by an injection under the skin, or Coumadin -- also called warfarin -- which is an oral pill. If the patient can be put in normal regular heart rhythm then no anticoagulation is needed. A pacemaker can fix some of these rhythm problems.
MDS is myelodysplastic syndrome. There are several kinds of MDS. Some involve abnormal white cell formation. The white cells are formed in the bone marrow and combat infection. Others involve abnormal red cell formation. The red cells also formed in the bone marrow carry oxygen from the heart and lungs to the rest of the body. I can find no mention in the medical literature that anticoagulants are linked to MDS. Some MDSes are effectively treated with some drugs commonly used in treatment of leukemia. Younger patients with MDS are often very effectively treated with bone marrow transplant, in which the patient's bone marrow is destroyed by chemotherapy and a donor bone marrow used to replace it.
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