Guidelines for anticoagulants in females

[Lindaj754]

Have paroxysmal afib. 2 episodes in 2 years. Will be 65 next year. Will I have 1 point or 2? Confused by recent guidelines saying gender should not be an issue. At the moment do not take apixiban

[Hidden]

Hello Linda, I understand that there may be some confusion, but I’m afraid you certainly get 1 because you are 65 years young. As I understand it, the “being a female” point is connected with oestrogen and the menopause, but I am not medically trained and I’m certainly no expert in this area! Sadly, it does look as though you will score 2 on the CHADs......

[Polski]

If 'gender is no longer an issue', then you have 1 point, but remember that this is only a guide line. You have to decide, with your doctors, what is right for you. As your AF is so infrequent, you would probably manage OK without an anti-coagulant, but may feel more confident if you take one. Remember - one stroke is one too many.

However, how do you know that you are not getting more AF of which you are unaware eg at night? If you take that into account, then you will probably prefer to take one. But the other matter to take into account is the risk of a bleed ocurring. There are no easy answers here, so consult your doctor who can take into account any other health problems you may have. AF may not kill, but AF plus other things can. So think carefully, and go see your GP!

[fnurd in reply to Polski]

The guidelines (and all the cardiologist I have worked with) say that if you have paroxysmal AF you should be on an anticoagulant even if CHADS-VASc is 1.

[Lindaj754 in reply to fnurd]

Interesting. Is this in USA ? I have been told at the moment my risk is lower than that of a bleed. Certainly when I get to 65 things change

[doodle68]

Hello Linda I am posting a link below to what I think is an updated version of the Stroke Risk Calculator

CHA2DS2-VASc (which also contains a list of Anticoagulants available)

With regard to your question re 'females ', as I read it the female 'point' only comes into play when one or more risk factors are present and that could be reaching the age of 65...

You can check it out for yourself by playing with the calculator below and varying your age .

tools.acc.org/anticoag/?_ga...

[Lindaj754 in reply to doodle68]

Thank you for this. At the moment doctors in the uk and USA, where i spend some time, are in agreement that i take bisoporol and apixiban when I have an episode , stopping when finished. This is because of low risk. Makes sense that it changes at 65. I suppose in a strange way we look for a way of not having to take them!! Be nice to hear more positive news about apixiban!

[doodle68]

Hi Linda you say...

''the doctors are in agreement that I take bisoporol and apixiban when I have an episode , stopping when finished. ''

It may well be that your Doctors do not think you are at sufficient risk to need anticoagulants but my understanding is if you are taking an anticoagulant at all you need to take continually even if you only have occasion episodes of AF otherwise there is no point in taking them .

You also mention 'positive news about Apixaban ' do a search in the box at the top of the page for Apixaban for more information on members experiences. I have been taking it for a year and all seems to be ok except for an occasional rash on my back where I once had shingles so the rash may or may not be attributable to the medication I now take.

Doctors can advise you but the decision whether or not to take an anticoagulant is down to the patient. I know I struggled with the decision myself as did many members here. In the end a score of '3' and a strong recommendation to take an anticoagulant made the decision for me. I would advise doing lots of research on the subject .