I went to see mt GP today about an unrelated matter, but used the opportunity to ask him if I should be considering ACs now I have just reached 65. I am fit and healthy, have low BP, and no other co-morbidities that I am aware of. Having watched Dr Gupta's video on the relationship between AF and stroke risk, I've not felt an urgency to start on ACs yet. I was pleased to hear that the surgery uses the new oral ACVs as opposed to Warfarin, but he said it was a good question I had asked. Due to the irregularity of my episodes, he thought it would be introducing an unnecessary risk of bleeding to go onto ACs at the moment. He did say though, if I was much more regular with my episodes then we would need to re-visit the decision.

However, he did recommend taking 75mg of Aspirin. I mentioned how Aspirin is almost a dirty word on forums like this, and he admitted to it being a 'fudge' or halfway house to ACs, but that it did lessen the risk slightly without tasking on the severity of the risks associated with ACs.

37 Replies

  • Sorry but I do not agree with his assessment of low risk. Aspirin can cause stomach irritation and bleeding for almost zero benefit where AF is concerned. OK different if you have stents or artificial valve etc but other wise no.

  • There do seem to be some in the medical profession who still consider it though. When I was first diagnosed in A&E, the cardiologist prescribed bisoprolol and aspirin and told me to schedule an echocardioogram.

  • Yes I was on aspirin for about five years before warfarin and had far more problem for no benefit. There again that was fifteen years ago and hopefully some of us have learned something since then. Maybe not.

  • Perhaps your GP is one of those who thinks patients like to have something to take as it makes them feel better? I had a GP many years ago who would write your name on his prescription pad when you walked into his surgery and you always left with something, even if it was vitamins. And aspirin is very cheap compared with NOACs.

  • Lol. That is so wrong but your post really made me laugh!!!!

  • Good!

  • Haven't posted for a while.I thought doctors had all got the message by now, as well as following NICE guidelines.

    4 years ago ,when I was 58 diagnosed with AF, no other co-morbidities and low blood pressure. Told to take aspirin and I didn't need to be anti-coagulated because i was to young. 3 months later TIA followed by a stroke. Then I was prescribed Warfarin and now take Rivaroxaban -a case of after the horse has bolted.

    Please don't let it happen to you.

  • Okay, I accept the argument against aspirin but you are also going against Dr Gupta's advice. Who'sd to say you wouldn't have suffered a strokr anyway irrespective of your AF.

  • You would also have had a CHAD2VASC score of 0 and so there'd be no reason to be put on ACs according to the NICE guidelines. You could have just been one of the unlucky ones.

  • I don't know if applies now but at the time ,if I remember correctly, I would have scored 1 because I am female.

  • A female aged 65 or over will score 2 on CHADSVASC, a male 1 with no other co-mormidities.

    True, you don't know who will have stroke and who won't but personally I want to reduce the risk. Just because I have the occasional AF episode my stroke risk is 1 in 5, as will be yours. With AC it reduces to less than 1 in 10 - I prefer those odds.

  • No it isn't 1 in 5. This has been covered extensively elsewhere. It's a generalisation that takes into account those with comorbidities.

  • In 2014 I had been told that I did not need anticoagulants until I was 65. I had a stroke in 2015 aged 62. I had AF, low BP, I was healthy. I asked the discharge neurologist to prescribe Pradaxa. I paid to see an EP who told me to discontinue with aspirin. I was prescribed Bisoprolol and Fleicanide.

  • Okay, but there are also people who have gone for the ACs and then suffered a cerebral haemorrhage, so it can work both ways.

  • Yes but the odds are much, much lower than stroke risk from clot forming after AF - providing no other contributing factors.

    Risk:benefit ratio always applies.

    There are nowt so deaf as those who do not want to hear though.....

    It is always personal decision - whatever you decide - long and healthy life to you.

  • Precisely and as I have no comorbidities my GP sees a bleed risk as been higher than a clot risk at the moment based on my personal circumstances.

  • The incidence of strokes in Europe is far lower than here because they do not allow AF patients to wait until they are 65 before prescribing AC's.

    GP's are far less informed than EP's. Pradaxa only a half life. There is a drug called Praxbind, which is a fast acting antidote which reverses the anticoagulant effect.

  • There have been 9 studies carried out, 8 of which have proven that aspirin is of No benefit in reducing the risk of an AF related stroke. One study indicated some benefit but only at a very high dose of 375mg Daily. Aspirin carries the risk of gastric bleeds so definitely there is no point in taking it for no real benefit. Warfarin and NOACs prove efficacious in reducing the incidence of AF related strokes. I know the fear of Stroke is very real with AF especially when so many people are ill informed and offer emotive advice because of anecdotal evidence. But the research and evidence as it stands is based on the Chadsvasc score. Incidentally, your GP should be prescribing NICE recommended anti coagulation regardless of the frequency of your AF if your chadsvasc score indicates so. Chadsvasc is a risk assessment and your score does not alter according to frequency . That means it does not alter whether you are in AF for 5mins or 24/7. Best wishes:)

  • I think some GP's and even Cardiologists feel pressured by colleagues to cover all opinions. In 2008 my cardio (who I learnt to trust) visited me in hospital and said AC & aspirin when he was with 2 colleagues, later seeing him privately and after episodes stopped on Flecainide, he became quite happy for me not to take either.

    If you do decide to take aspirin I would take the enteric coated ones, slow release and easier on the stomach.

  • I have a hunch that Asprin will make a come back. It's very useful in cancer prevention and providing you don't have stomach ulcers it can prevent clotting. If stroke risk is high then clearly AC s are needed. They too come with risks. When I took them I didn't feel well as I was bruising so easily. I was bleeding profusely and was not relaxed. My AF was two incidents only in a year. I'm pleased to say magnesium or good fortune is keeping further attacks away.

  • Hi Elaine, I'm curious to know why and what benefits are in you taking magnesium for AF?

  • I suggest looking at dr Sanjay Guotas utube s. It's well proven to help. Also Hawthorne

  • I would trust the GP. Personally, I was very unhappy to go from Aspirin to Rivaoxiban. Whilst on Aspirin I had Omeprazol to protect my tum. Aspirin helped me with hip pain too. Now on Rivaoxiban I worry about bleeding, or forgetting them, with the added problem of being very limited as to what painkillers I can take. Every case is different. If you are unsure, could you ask to be referred to a cardiologist to talk it over?

  • Hi Alan,

    did you consider using some natural suplements (for ex Turmeric ) having anti-coagulation effect beside of other positive health effects (anti-inflamatory, anti oxydant)?

  • Hi Arveno, how is taking Turmeric helpful for AF?

  • Hi RaquelP,

    I did not found anything and know nothing about Turmeric and AF. I woul like use Turmeric for its anti-inflamatory and blood glucose decreasing effect. But I will not use it because it can increase risk of bleeding interacting with xarelto, which my husband is using.

  • Not yet. What I don't totally understand though is why Aspirin is meant to be useless. It has 'blood thinning' capabilities as the GP said so why is it so ineffectual for AF? My GP agreed it was no match for ACs but he said it would help.

  • Alan, to whom you adress your question about uselessness of Aspirin? I do not have any opinion about Aspirin. Possibly there have been rapported some negative bi effects. Try google on it and make yout opinion.

  • Read through many of the threads on this site, and aspirin is treated as the 'enemy'.

  • I know what you are saying Alan. Im 63, no other health risks, EP says no anticoagulants til 65. Cardiologist says take aspirin. So I am taking 81 mg of aspirin as it does have other health bennefits. I get what " the studys" say re a fib/stroke/aspirin but it is used alot here in the USA. Im an RN, orthopedic surgeons here have patients take aspirin a month after surgery to prevent deep vein thrombosis, etc. Studies showed aspirin was superior to warfarin, and others. So, Im not saying studys are wrong but research is research. 10 yr from now who knows what will be recommended. I tried to convince my EP into anticoagulant now and he said not before Im 65. Its a coin toss. We are active, still ride our horses etc so only God knows if Im at more risk of stroke or falling off my horse and bleeding out as we are 40 miles from healthcare here.

  • I know, it's so difficult knowing who or what to believe. The medical professionals are meant to be the experts but there's even conflict of opinions between them. This forum is a wealth of information but there are a lot of people here who are very entrenched in their beliefs, even when evidence to the contrary appears. There are even studies in the US regarding using ACs as a 'pill in the pocket' solution for when AF starts which seems to contradict the 'fact' that you are equally at risk of a stroke whether your AF is irregular or permanent. The risk of cerebral haemorrhage if you are on ACs seems very played down to me on here, yet it appears to be a very dominant thought when it comes to GPS, and I don't believe they are just trying to save money by talking you out of taking ACs.

  • I agree. My EP is employed by a large teaching University/hospital. He has nothing to gain or lose by what he prescribes. He just goes with recent data. He rejected prescribing anticoag to me at this time as the risk outweighed the bennefit.

  • That's why they developed the HASBLED scoring system which should be used along with the CHADS VASC assessment so individual balance of risk can be worked out -as much as this is possible.

    Re your comments on Asprin being seen as the "enemy' here, people are just quoting the NICE guidance which is formed from a large number of medical opinions- I think also a study showed Aspirin only has a limited AC effect but is good for those whose platelets need attention in certain conditions-

    Bleeding risk is high too with Aspirin- we all have to look into these things ourselves as there are so many conflicting views but it may be wise to accept the consensus on this as it's based on a lot of clinical experience with actual patients- similar to accepting the clinical view that we are at risk of stroke with AF- this is also based on the observations and numbers of AF patients who have stroke if not anti-coagulated

  • Aspirin is not a recommended treatment for preventing venous thrombosis in arythmia. Just stroke or heart attack.

    I attack green it has Bob you have more risk of Aspirin related side effects than any benefits

  • What I don't understand is why, seeing as it described as a 'blood thinner'. I would have thought anything that had that type of effect would have some kind of benefit, however minor. I was put onto aspirin by the cardiologist in A&E and took one a day for a few months until my GP recommended coming off them and I was aware of no side effects during those months.

  • Aspirin is an anti platelet not an anticoagulant. NICE guidelines recommend true anticoagulants as therapy and that aspirin is ineffective in af due to its antiplatelet properties.

    Can't attach the research but Google nice guidance aspirin in af

  • If I was you I would read the NICE guidelines check the stroke association and AF association read relevant scholarly articles. Check the difference in anticoagulants and aspirin. Digest it all and go banging on the door asking for anticoagulants.

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