Aspirin Facts

[cdeterra]

In several posts, I've seen references to NOT using aspirin. What is this about? Does anyone have any links to research about it?

Background: 50 year old female. Diagnosed with AF in early June 2014. Could not control it with medication, and I stayed in AF constantly. Had ablation in July 2014. Now feel fairly recovered. I was originally put on Eliquis, but ended up with a significant bleeding episode. They took me off everything except 325 mg of aspirin each day.

There is a history of blood clots and strokes in my family, so I'm concerned with being proactive. Is taking aspirin dangerous? If so, why?

[BobD Volunteer]

Aspirin is only dangerous in as much as it can cause stomach bleeding but it is of little value in stroke prevention for those with AF and this was reflected by NICE removing it from stroke prevention guidelines for patients with AF. It has some uses post stroke and if you have coronary stents or artificial valves etc but not as a prophylactic. This of course is in UK but US has posted similar guidelines I think. Maybe you need to discuss this in depth with the doctors treating you as you are obviously at risk from what you say. 325mgs seem a high dose as well to me.

Bob

[cdeterra in reply to BobD]

Thanks for the quick reply Bob! I'm going to contact my EP about this to see if I should go off it. I hate being on meds, so I'd be happy to see it go. May I ask if you had ablation, and if you stayed on some sort of anti-coagulant afterwards? I keep reading that even though I had the procedure I should still be on something to prevent stroke. I had a bad reaction to Eliquis, but I'm wondering if there is something else that would be safe? Both parents have had clots and stroke, so I feel like a ticking time bomb.

Thanks for your help! It is truly appreciated!

[BobD Volunteer in reply to cdeterra]

I had three ablations up to 2008 since when I have been AF free but I stayed on warfarin despite my EP saying I could stop. Stroke is one of the things I fear most so for me it is a no brainer. Many specialists feel it best to stay on anticoagulation for life since AF changes the atria in a way that can still allow clots to form even after AF has been terminated. Unfortunately the CHADSVASC system for risk assessment doesn't take family history into account so you may score low . I wish there was a guideline that said if you have AF then you should be anticoagulated but it is still rather vague in that respect.

There are still three other NOACs plus warfarin which could be tried but if you have a history of bleeds then it all becomes rather outside my sphere of knowledge I'm afraid. Do speak to,your EP .

Bob

[MarkS]

Hi Cdettera,

There is this trial:

sciencedirect.com/science/a...

which compared warfarin to aspirin and a placebo. 1,000 patients were split into the 3 groups. 5 patients on warfarin had a stroke compared with 20 on aspirin and 21 on placebo.

If you don't want to try another of the NOACs, then warfarin is still a very good alternative, particularly if you get a monitor. That can ensure you remain in the appropriate range and don't go too high, which can cause bleeds.

Mark

[cdeterra in reply to MarkS]

Hi Mark:

So if I'm reading the study correctly, it basically proved that aspirin did slightly less than nothing to prevent clot/stroke, etc. So annoying because I've had to take a stomach medication in order to tolerate the 325 mg aspirin each day, and it is all for nothing. I'm going to contact my EP this week to talk to him about warfarin.

Thanks for your help!

[Dodie117]

I had an ablation last year and taken off all meds except warfarin. I would not be happy not to be anticoagulated but as all the experts now say, aspirin is not one of the options - it needs to be warfarin or one of the noacs.

Although warfarin needs monitoring, I have my own machine to do this so once levels settled down I do not need to go to doctor/clinic very often.

Sounds like you need to arm yourself with information on this issue and then discuss your particular circumstances with your EP.

Good luck.

[cdeterra in reply to Dodie117]

Thanks for this! Seeing the EP is my plan. He's sort of used to me coming in armed with research and with my own rather strong ideas about treatment, so this won't be a big surprise.

Thanks all!

[ZVI-]

Hi

had my ablation about 4 weeks ago.in boston..was on eloquis prior...and a 81mg asa...now on eloquis with a 325mg..there is all sorts of pros and cons about in research about the aspirin.....the blood thinners don't bother me and will stay on

it is the mutaq that makes me feel sick all the time...was an avid runner before afib..and i truly believe multaq is slowing me down and causing constant fatigue

[Wightbaby]

59 years old, skinny (see profile pic!), and fit. Diagnosed with PAF and only on a beta blocker (to be taken during episodes) and 75mg Aspirin a day. I suffered a blood clot in my right arm -18 months ago...been on Warfarin ever since.

Personally i don't think Aspirin is enough "protection"

[cdeterra in reply to Wightbaby]

Wightbaby:

I'm starting to feel the same way!