Taking aspirin for AF.

[ruthalem]

My husband was diagnosed with AF 7-8 years ago, his GP prescribed 300mg aspirin daily, he has taken it from day one of being diagnosed, I worry that he may have a brain bleed, am I worrying unnecessary.

[Beancounter Volunteer]

Hi Pamela

There is not a lot of support for aspirin as the sole anti-coagulant for AF, in fact most EPs and Cardio Specialists advise against it now. However Doctors seem to want to stick to it, and they are sometimes hard to move from their fixed opinions.

As you probably know the real big risk with AF is stroke, and that is why his doctor and all others usually prescribe an anti-coagulant. Aspirin is an anti-coagulant, but it works quite differently from Warfarin and the others, and you can research this yourself on the internet loads of webpages talking about this.

Now IF your husband had a low risk of stroke, (and there is something called the CHADSVasc score which checks this) then a low dosage of aspirin might well be appropiate not least because there is some evidence that low dosage aspirin assists with any potential heart problems (Not AF). But a low dose would usually be 75mg a day, not 300mg which seems like a high dosage. Of course aspirin also is prescribed for anti-inflammatory purposes such as arthritis, is this what the aspirin is for?

I am not medically qualified, but I would suggest that your and your husband go back to the doctor, firstly ask for his CHADSVasc score, and then have a chat about the usage of aspirin to prevent stroke rather than warfarin or one of the new anti-coagulants.

Has your husband seen a specialist? what does he say, and how often is he seeing them?

Anyway trust this helps, and please ask any further questions, this is exactly the right forum

Best regards

Ian

[ruthalem in reply to Beancounter]

Hello Beancounter, Thank you for your quick response,My husbands CHADSVasc score is one, which I have been told,is low, but even so I am still not convinced that 300mg of aspirin every day is a good way of trying to cut the risk of a stroke.

[BobD Volunteer in reply to ruthalem]

Pamela , I respect much of Ian's view but would say that whilst aspirin is a blood thinner it is not an anticoagulant. IE it doesn't stop clots forming. As an anti-patelet it thins the blood but doesn't stop it clotting and clots are generally what cause strokes. Although bleeding strokes are not unknown they are less likely than thrombotic (clot )strokes. I would not want to be on 300mg aspirin a day for anything as the risk of stomach bleeding far outweighs any benefit it may give.

Sadly GPs are locked into the outdated view that aspirin is the wonder drug for just about anything and they are wrong. Britain has one of the lowest number of at risk patients on proper anticoagulants in Europe and getting this message across to GPs would stop up to 8000 strokes a year. There is a new website stopstart.org.uk which is aimed at GPs and other medical practitioners where the newest thinking can be viewed so I would suggest that you invite your doctor to have a look at this site before he comments on anything we may have suggested.

You are right, it is not a good idea and you must question it.

BobD

PS my Chads2 score is 1 also and I elected to take warfarin these last five or six years.

[ruthalem in reply to BobD]

Thanks for your input BobD. My husband has an appointment to see his GP 19th August.to ask if he can take an anticoagulant instead of aspirin. And to ask if it would be a good idea to see a cardiologist. It will be a help, I am sure, if he can express why he would prefer to do this, so thanks for all the information and advice.

[ruthalem in reply to Beancounter]

Hi Beancounter, My husband was diagnosed with AF six or seven years ago but has never seen anyone other than his GP.

[Beancounter Volunteer in reply to ruthalem]

Hi Pamela, yes he must see a specialist, your local GP should ideally have referred him seven years ago, not now, and if I gave any impression that I agree with the aspirin, then I apologise, the 300mg of aspirin is far too high and he should be on warfarin or similar.

I think you should be a bit more forceful than "ask if it's OK to see a specialist, I would be asking why not.

Best of luck however

Ian