According to this calculator, I am no more likely to have a stroke than someone of my age without AF (I am 37 yo)... can this really be true?????
CHADS2VASC feels like too crude a formula for my liking. I’d much rather see hard statistics and make the decision for myself. Can anyone refer me to any statistics on the probability of AF sufferers having a stoke as age varies…. Or should I fully trust CHADS2VASC?
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Mejulie69
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HASBLED is not so much a score as an aide memoir of things to address before anticoagulation. This is not generally understood even by many doctors. You should not try and match one against the other rather deal with such things as high blood pressure.
I agree that CHADVASC is far from ideal and many people with a score of zero have gone on to have strokes but it is still valid. Having a score of zero does not mean that you are no more at risk than a non AF person as AF is known to make one five times more at risk of stroke especially if other factors apply. Agreed if your stroke risk really is zero then five time zero is still zero but how do you know it is.
I don't get CHADS either. If you have AF then you are apparently more likely to have a stroke.
I'm in the position of having had bad AF for 2 decades maybe longer, and for quite a lot of this time it was virtually continuous. So, logic tells me, that if AF can cause pools of blood to form around the heart (or wherever), then I'm very likely indeed to have this potentional problem. But until I reach 65, my CHADS score was always zero, now it's 1. Does that make any sense? Not to me.
My EP has had me anticoagulated throughout regardless of CHADS and when I questioned him about it he just ignored the score.
Taking anticoagulants isn't a guarantee of not having a stroke, it just reduces the risk. My father-in-law, who is on Apixaban (low dose), just had a mild stroke (but he's OK, just affected his speech a bit). Maybe it would have been worse without Apixaban? You never know really.
Quite true, aFib is just another risk factor. There are side effects also, like hemorrhagic bleeding which could be a killer. Use of anti-coagulants is big money to the drug firms who're pushing non-warfarin drugs under patent. Otherwise they'd not be taking out full page ads in every newspaper. For most physicians its a knee jerk reaction. aFib=anti-coagulant. According the the NIH 62-67% of all patients experience some bleeding with anti-coagulants. Physicians are not mindful of the consequences and they prescribe them like candy.
"5 times" is obtained from data for a wide range of people, and must be considered an average figure. For some people the risk will be much lower; for others much higher.
Indeed it is and that’s why I decided to follow his advice.
There is also the factor that AFib strokes are the worst. I forget the figures, but last time it was quoted on here, the percentage of bad strokes associated with AFib I recall is a massive figure. So, logically, the 5-times figures isn't really correct. If you look at bad stroke instead of all strokes, it's got to be far higher than 5-times surely.
But I'm a farmer 👨🌾 not a mathmetician 👨🎓, so do NOT take my word for it !!!
Yes, that's accurate up to a point. Have you had any side effects after anti-coagulant therapy? It's important not to stop dosage since once you take this road. You cannot cease without consequences as well. Once committed one is wedded to the therapy for the duration. Side effects are present in a statistically significant portion of patients on this therapy and some anti-coagulants don't have antidotes to reverse the adverse effects. That's why warfarin, although it's a pain in the butt to monitor, is still the therapy of choice by many physicians. It's relatively easy to handle. My personal experience with warfarin was horrendous. It caused hemorrhagic bleeding in my eye (and blinded me until surgery corrected the leak) and alimentary involvement encompassing pancreatitis and intestinal bleeding. I know. I'm only one person out of many who haven't experienced these extreme affects, but still. Be careful and watchful! For me anti-coagulant therapy is not a valid choice. My CHADS profile has me at a four per cent chance of stroke (which is not significant). But my experience with warfarin or any anti-coagulant could prove to be lethal.
Only side effects I've had was with Warfarin when I first started some 10 years ago. I got a small amount of blood in one eye. Had it looked at and then it just cleared up. Nothing since then that I am aware of. But it is a balancing act and it is definitely a choice of the "least worst" route you wish to take.
The CHADS scale used by most practitioners is also now questionable, following recent advice from the 2017 European Stroke Conference that women should no longer be awarded a point on the scale purely because of their gender:
'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.'
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