Don't think this has been posted already - apologies if it has;-
bbc.co.uk/news/health-27760736
I suppose the question for those of us already on Warfarin is do we push to be put on the "newer anticoagulents"?
Oops, I see someone did post it before me.
Yes a cardiac nurse told me this last month. I'm being put on one of the newer ones when my EP eventually sends his letter to the GP...
There was also just a great piece on the Today programme on radio 4, about 5 mins ago.
Interesting of course now the cat is out of the bag so it were. I also read somewhere recently that only about 3% of patients are on the NOACs whereas NICE expected up to 20% to be so by now.. This is clear indication that GPs are not having the best interests of their patients in mind and rather going with costs. Either that or they are plain ignorant of the truth. Still a long way to go but a least some progress.
Bob
Thanks for posting, very interesting! 
Yeah, saw this about Asprin - but its not new news - its now just been formalised, as it were.
I'm on warfarin - have no desire to go onto new stuff thank you - I have no problems with warfarin, so, if it ain't broke don't fix it. I understand that the new stuff is great for people who just can't handle warfarin for any one of a number of reasons. In respect of Pradaxa/Dabigatran, I've read enough from the Australian Government Dept of Health to put me off that anyway.
Aussie John
I'm with AussieJohn on this. I have no problem with warfarin except for the atrocious taste. Why aren't they coated? I feel very cross that I was prescribed aspirin by a very rude and cocky doctor at Wrexham Maelor Hospital. Those aspirin upset my stomach, and all for nothing, yet leaving me unprotected.
Yes, I agree - I'm happy enough to stay on Warfarin. It will be interesting to find out if we get some sort of "sales pitch" for the new anticoagulents from our doctors now though, my guess is that mine (who I trust and respect) will be happy to leave things as they are.
Here in Wales the new anticoagulants aren't on offer except for very specific reasons. In view of their cost I have to agree with this. The NHS is not, and cannot be, a bottomless money pit.
Ok now reading the full guidelines, all 420 pages of them, I should finish sometime this week.
But for me the stats from the intro just make me gasp.
1) Only 55% of those in AF are on anti-coagulants, and that is those reccomended to be on them.
2) in the first THREE months of 2013, 11,939 stroke patients admitted, of whom 1/5th were in AF on being admitted and of these 1/5th 36% on an anti-coagulant, 38% on aspirin, and 26% on nothing at all.
If we extend that then it's truly terrifying.
Roughly 48,000 people a year admitted for stroke, of whom 9,600 are actually IN AF when admitted.
Of those 9,600 3,456 are anti-coagulated, 3,648 are on aspirin, and 2,496 on nothing at all.
That's almost criminal, whilst I am sure that some might never have know they were in AF, the 3,600 on aspirin surely knew, and many of the 2,496 would have been diagnosed with AF.
Ian
They are incredible, and pretty depressing, figures - I would never have come up with anything close to those percentages if someone had asked me to guess them beforehand.
Looking at these figures it suggests that nearly as many people on anti coagulants had strokes as those aspirin.
Yes it does, but without knowing other reasons, patinet history etc, and of course outcomes of the stroke then this would be a misleading observation if I may say.
What it does NOT signify is that aspirin is equally as effective as an anti-coagulant, for example we know that AF strokes are generally the worst kind, but that anti-coagulants mollify the effect even if one has a stroke limiting the damage we'd need to examine outcome data to prove that with this sample.
Ian
Yes, it would be very interesting to know the outcome in each group.
I read somewhere that a large proportion of people who were on warfarin that had a stroke had an out of range I.N.R. when admitted to hospital. More frequent testing, help with purchasing of monitors and strips or eventual shift towards the new anticoagulant that don't need monitoring would make sense if this statistic is correct. Just wish I could remember where I saw it. X
According to to-day's Daily Mail the cost of warfarin is £1 per month plus the cost of clinic visits. The new anticoagulants can cost £64 per month.
Hi all,
i have just be told i need to go back on Aspirin after i was told 18 months ago to stop taking it. I've also been told i need to go on statins...
i'm off to see my doctor this friday to get my new prescription of statin (already on Soltalol for my AF)... now this has come out in the news do i accept the prescription and Aspirin advice or tell them this old news now and i should be on another anti coagulant?? I am quite worried now but don't want to cheese off my doctor by seeming like i know more than he does.. which i don't... nightmare!!!!
Hello Pauly, to me the NICE guidelines don't leave any room for argument. This, taken from the BBC link I posted earlier on,
"Prof Peter Weissberg, medical director at the British Heart Foundation, said: "Strokes caused by atrial fibrillation are both common and preventable but only if the abnormal heart rhythm is identified in the first place and if effective drugs are given to prevent blood-clot development.
The revised NICE guidance reflects accumulating evidence that warfarin and the newer anticoagulants are much more effective than aspirin at preventing strokes."."
makes it clear and I'd take this or some newspaper cuttings featuring the story along with you to show your doctor.
I take your point, but as someone with AF who has been told he should start taking Aspirin again, I think Pauly should at least bring today's developments to his doctor's attention and, if it is the correct decision in his case, have why it is considered to be explained to him.
N.B. This reply was for slipmaster.
Hmm i am on both aspirin and warfarin as advised by my consultant, i do have other heart problems as well as AF so i quess it depends on the individual circumstances and is not as clear cut as the news is making out.
Hi... the above comments make for interesting reading.....
However .my husband who has Paroxysmal AF has been taken off aspirin....by the time of his next apt with the GP a month has gone by with no anticoag cover.
What he can't understand is why......as aspirin prevents the platelets in the blood from forming a clot ...its called an Antiplatelet agent ....warfarin has a chemical effect on the blood causing the clot to form slower its called an. anticoagulant.
Both do a similar job.....As for this new drug there seems to be far too many people
telling us how good for patients it is. Cost wise who gains
60 tablets cost £76 plus vat
Hi Budgies Mum
OK your husband needs to do CHADS2VASC test for himself, google it and you can do it for him, any score above 1 and he needs to be on an anti-coagulant and not aspirin.
Aspirin is an anti-platelet, but that is the not the cause of AF related strokes, in fact with aspirin you have more chance of a bleed (especially gastro-intestinal) and no cover for AF related stroke whatsoever.
Do the test and then get back to your GP ASAP
This is nothing to do with the new drugs, warfarin is cheaper than aspirin, and he would be fine on that.
Ian
Hi, have already done the test.... score 2.
that is on age only. His hospital cardiologist with a good many years experience felt aspirin in my husbands case was best. He did not want to give warfarin. Looking at the stats theres almost as much chance of a bleed with warfarin as with aspirin.
In the 7 yrs on aspirin since theParoxysmal AF was diagnosed he has had no gastric side effects.
Paroxysmal meaning intermittent. In his case extremely few times. Only once in 5.5 years did my husband present fibrillating at opd clinic.showing on an ecg, but gone within minutes.
But apart from that, no one takes into account the patients overall condition. My husband is much fitter &healthier than men 10 and more years
younger......75 is just a number.
why at 74 yrs would he be given aspirin and at 75yrs warfarin. ????
J.
Hi Budgiesmum
I'm sorry but many here would disagree that's because they have had strokes or TIAs because their doctor did not prescribe an anti-coagulant.
Today's guidelines are crystal clear from NICE aspirin is inadequate in preventing stroke for an AF patient, they must be anti-coagulated.
The overall condition is not really relevant, those few minutes of AF are enough to potentially start a clot in the healthiest person.
Aspirin is not recommended at 74 by the way, it's never recommended for AF.
Eventually of course it's your choice, but warfarin is easy to take hardly any diet changes and you need a few blood tests, it's my very best friend as with it I am less likely to end up in the corner drooling for the rest of my days.
Be well
Ian
Yup - I'm with you - warfarin and I are buddies - intil a better best friend comes along
Hi......maybe what your saying is right ...maybe your going with the flow..
In my husbands case in his late 60's he was given aspirin 300mg daily till his heart man retired. Two years ago at the age of 73.5yrs
his Gp reduced the dose to 75 mg daily. It is only since this latest drug Pradaxa has come into fashion has the Gp said or done anything........ Infact the Gp pushing Pradaza discontinued the aspirin.which was followed days later by an ecg and 24 hr tape. Apart from an odd message Via the receptionist...about taking warfarin.........nothing more. I rang back and booked an apt.
But by the time of the next Gp apt. My husband will have been left without any anticoag cover at all for a month.
Am I an unhappy bunny......you bet ya..
Words will be said. By the way,......
My husband will go onto warfarin.....
Cheers.
J.
Your views on stroke prevention treatment in AF
do statins prevent strokes or is it myth? Any support to answers welcomed
Aspirin 'Resistance' May Make for Worse Strokes
Aspirin
