Dr. John Camm from St. George's Medical Center, London, wrote an article stating the big news is that in the 2017 ESC stroke Risk guidelines for Afib "gender is no longer an important consideration ." This change is historically significant as Dr. Camm was one of the principal authors of the original CHA2DS2-VASc guidelines which automatically gave a women one point on the stroke scale.
My doctor in the US agrees with Dr. Camm and is using this new guideline for all his women patients.
No doubt AF Association will mention this in the next news letter and hopefully I will be able to talk to him at HRC in a months time and get some background on it.
That's odd, this article containing the information above is dated 'January'.
When the Cardiologist nurse and my GP calculated my risk score in May I was awarded one point for gender as well as one for age. It seems this information has not filtered through to some health care professionals and to the CHA2DS2-VASc score charts.
Quote....
[New 2017 European A-Fib Stroke Risk Guidelines Changes & No Gender Bias
by Steve S. Ryan, PhD, Jan 19, 2017
Dr. John Camm from St. George’s Medical Center, London, UK discussed the new 2017 ESC (European) AF Stroke Risk Guidelines (i.e. CHA2DS2-VASc) compared to AF guidelines used around the world.
Gender Bias Reversed: The big news is that in the 2017 ESC Stroke Risk Guidelines for Atrial Fibrillation “gender is no longer an important consideration.”
The previous CHA2DS2-VASc risk scale automatically gave every woman with A-Fib an additional 1 risk point for just being female. Under the new 2017 Guidelines, anticoagulation recommendations are the same for men with 1 point as for women with 2 points. (“Sc” stands for sex i.e. female gender). This is a major change in anticoagulation treatment for women.
I've wondered if it had been taken into consideration in assessing stroke risk the fact that women tend to live longer than men. When I was an A level student we did a demography study. (I was in Southport (on the Lancashire coast) which has an odd population with far more old people than most places have.) I remember at the time (1965) that nationwide more boys were born than girls but by18 they were even and by 80 there were two women for every man. Had it been noticed that twice as many women have strokes and a theory developed that women are more prone without regard to the fact that there are more elderly women than men?
So if you are female and over 65 you should be on anticoagulants which I am and have been for the last 2 years. But I am now being told I need not have taken them (REALLY!) What on earth is going on? So now what do I do?
I'm in the same position as you, souljacs and I intend to keep taking Apixaban until my cardiologist tells me otherwise.
Me to it took me so long to make up my mind to take them in the first place.
I had an A/f induced stroke at the age of 56 and been on anticoagulants ever since and I am now 73
May I ask what anticoagulant are you on for all those years? Thank you so much!
Warfarin however I started on Pradaxa 3 months ago due to having TIA's, 5 since February, the stroke doc felt that Pradaxa would protect me better than the Warfarin now and so far so good. From diagnosis to stroke I had been taken 375mg soluble aspirin a day and initially after the stroke I took 75mg aspirin together with the Warfarin!
Thanks for this news - potentially wonderful for me as I would love not to have to be on anticoagulation. Yes, it does take time for any new research to be analysed, verified and then filter through to practitioners.
Hi Kathy 
is there new research or just an inconsistency of interpretation. I can find no 'new' information in the NICE guidelines.
I have however found this which states more clearly than some interpretations of the score that a '1' for gender should not be used in isolation and should only be taken into account if there are other risk factors eg if you are a woman under 65 with no other risk factors discount the 1 risk point and give youself a score of 0, if however you are over 65 that point comes into play giving you a score of 2.
["high risk" category compared to CHADS2.
Gender and the Caveat to CHA2DS2-VASc
In general, a CHA2DS2-VASc score of 1 should warrant strong consideration for full oral anticoagulation.2 The one exception, however, is in patients who have a score of 1 due to gender alone. In these patients (female < 65 years old without other risk factors), antithrombotic therapy should not be given. This special situation may not be intuitive with the CHA2DS2-VASc scoring system.]
webcache.googleusercontent....
I am over 65 so I get the extra point , this is how I interpret it .
This Nice flow chart carries the date 2017
which says the same as the above quote..
[Do not offer stroke prevention therapy to people aged under 65 years with atrial fibrillation and no risk factors other than their sex (that is, very low risk of stroke equating to a CHA2DS2-VASc score of 0 for men or 1 for women). (For information on CHA2DS2-VASc see the ACC atrial fibrillation toolkit.)]
I think it's looking at studies. Here's an article on it, mentioning Swedish, Danish and Israeli studies on the stroke rate for women with AF:
file:///Users/Katherine/Desktop/Controversy%20Women,%20Anticoagulants.webarchive
Hi All. I find this very interesting as I have a chads score of 2 purely because I'm over 65 and female, I have Paroxymal AF, 2 episodes in the last 10 months, I don't have any health issues at all and am very fit, couldn't change my lifestyle, 52 kg and walk on average 30 mile a week, BUT my mother had AF, she took a beta blocker and got on with her life, she died aged 97 this year. This is going to stire things up a bit for people like me, I'm not questioning why other people do take anticoags just do people like me really need them. I have been prescribed apixaban but have yet to start them. I do take Bisoprolol 1.25 as I have a low heart rate anyway and thanks to all your information folks I also take magnesium.
I have permanent AFib, and on warfarin. I have been reading about Magnesium lately and want to try it, but afraid. What dose do I start out with, and what about the warfarin I'm on. Do I lower my warfarin dosage, or just start out with a tiny bit of Magnesium? And what type of magnesium do you take? Sorry for all the questions. So happy for you that your Mum lived to be 97! My Mum had a pacemaker but we never knew why. She lived to be 81, and she too enjoyed life! Thanks!
I've just posted about this change on Dr Sanjay Gupta's Facebook page, asking for his comments.
I suppose anyone with doubts could go back to the old CHADS2 score which doesn't take into account gender or those under the age of 65 ..
mdcalc.com/chads2-score-atr...
but would NICE who seem to think cutting costs is of major importance have sanctioned the use of expensive drugs for thousands more people without good evidence to show it would be beneficial....
That's another one to think about doodle, a lot of the time GPs leave the choice up to us, which mine has.
Yes that is so Stivvy the the final say in the choice was mine too .
However in a letter dated May this year to my GP the consultant stated....
'' Mrs S would like to avoid medication if at all possible however she is aware that if the evidence of the ECG concludes that it is atrial fibrillation then anti coagulation will be recommended''
So to refuse anti coagulation would have been going against the recommendation of a consultant.
Wellllll I am 60 and on anticoagulation, so I get that score of 1 for gender alone. But then my cousin, who is male and also has AF, had a series of TIAs in his late 50s, so I would feel a little uneasy if I were not on an anticoag. Maybe I'm stupid, but...
I don't think you are stupid at all I feel the same
Me too!
Like I said this is going to open up a lot of questions, it will be interesting to find out other people's thoughts. I never saw a cardiolagist or an ep was just Reffered to my Gp so paid private a couple of weeks ago as my Gp wouldn't refer me the cost was £320 , at the end of the consultation he told me I had a 2% chance of a stroke without anticoags, MORE TO THING ABOUT,
I'm on Pradaxa and intend to remain so. My sister in law had a AFib induced stroke a few years ago. She had gone against her doctors advice to take an anticoagulant, and instead took low dose aspirin. I'm not trying to fear monger but she is bedridden. I understand that AFib induced strokes generally cause more damage than others.
Stroke Risk From Afib & The Role Of Blood Thinners 
my Afib has gone persistent 
New to the AFib community.
87 years old but new to AFIB
New to AFib
