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Wednesday September 20 1:53 PM ET

Alternative medicines may complicate heart surgery


NEW YORK (Reuters Health) - Many herbal medicines affect blood clotting or interact with other drugs, so what your doctor doesn't know about your non-prescribed medicine use could hurt you.

Fish oils make clots dissolve faster, garlic and onion interfere with clotting, St. John's wort and Gingko biloba interact with warfarin (a widely used blood thinner), and ginseng affects digoxin (a common heart drug), according to Eric H. Liu and associates from Columbia University in New York. And the list goes on.

Concerned about how the use of these alternative medicines and other practices might affect cardiac surgery, the authors surveyed nearly 400 patients about to undergo heart surgery at their hospital.

In line with earlier reports, 44% of patients reported the use of one or more alternative or complementary medicine therapies. When prayer and vitamin use were included, the authors note, the figure jumped to 75%.

On a scale of 1 to 10, users gave alternative medicine a 7 for its effectiveness in fighting illness and in general health, according to the report in the August issue of the Journal of Thoracic and Cardiovascular Surgery.

Of greatest concern to the researchers was the fact that most patients had not broached the subject of alternative medicine with their physicians. In fact, only 17% of patients had discussed the topic and most of the rest said that they did not want to discuss alternative medicine with their physicians or surgeons.

``As new research expands our understanding of the benefits and dangers of alternative/complementary medicine,'' Liu and colleagues write, ``physicians and patients must be open in their discussion of complementary/alternative medicine use.''

Regardless of their willingness to discuss their use of alternative medicine with their physicians, patients need to be aware of the possibly dangerous interactions between alternative and conventional medicines. ``Because of the possible effects on surgical outcomes,'' the researchers advise, ''the American Society of Anesthesiologists has recommended that all herbal therapy be stopped 2 weeks before surgery.''

SOURCE: The Journal of Thoracic and Cardiovascular Surgery 2000;120:335-

-- (hmm@hmm.hmm), September 20, 2000

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