Is aspirin ok for stroke prevention - Atrial Fibrillati...

Atrial Fibrillation Support

31,309 members36,977 posts

Is aspirin ok for stroke prevention

Alphakiwi profile image
37 Replies

I took myself off Rivaroxaban and went back to prodaxa but found i still had terrible nausea all night. I went to a doctor yesterday. Told him i couldnt go back on those blood thnners. He put me on 90mg aspirin. What should i do. I have been on rivaroxaban for over a year now after being taken off pradaxa. I have a pacemaker to help with AFLutter

Written by
Alphakiwi profile image
Alphakiwi
To view profiles and participate in discussions please or .
Read more about...
37 Replies
BobD profile image
BobDVolunteer

Aspirin has no place in stroke prevention for AF adn can still cause harm. (gastro intestinal bleeding etc ) It is useful for some cardiac issues such as if stents or artificial valves are present , but not for stroke prevention.

Omniscient1 profile image
Omniscient1 in reply to BobD

100% agree with you but was only asked last week by the nurse in my annual medical why I wasn't on aspirin. Seems my local surgery haven't got the memo!

Sweetmelody profile image
Sweetmelody in reply to BobD

No simple answers. Depends on where you look. No wonder we're all confused about the appropriate use of aspirin—so is the medical field. I copied the following from Google:

“Low doses of aspirin — such as 75 to 100 milligrams (mg), but most commonly 81 mg — can be effective at preventing heart attack or stroke.

Apr 20, 2023

Daily aspirin therapy: Understand the benefits and risks - Mayo

Daily aspirin therapy: Understand the benefits and risks - Mayo Clinic

Low-dose daily aspirin does not provide significant protection against stroke resulting from blood clots and may increase risk of bleeding in the brain or …

Nov 2, 2023

Daily low-dose aspirin has little impact on stroke risk and spikes risk of brain ..

National Institutes of Health (NIH) (...

People also ask

Is aspirin good for preventing strokes?

Aspirin has been shown to be helpful when used daily to lower the risk of heart attack, clot-related strokes and other blood flow problems in patients who have cardiovascular disease or who have already had a heart attack or stroke. Many medical professionals prescribe aspirin for these uses.Dec 16, 2019

fda.gov › drugs › aspir...

Aspirin for Reducing Your Risk of Heart Attack and Stroke: Know the Facts | FDA

MORE RESULTS-dose daily aspirin does not provide significant protection against stroke resulting from blood clots and may increase risk of bleeding in the brain or …

Nov 2, 2023

FDA

BobD profile image
BobDVolunteer in reply to Sweetmelody

The critical pioint here is " for patients with AF" and yes it can increase bleed risk. Yes it has uses but for the purpose of this forum (AF) it does not.

WardijaWardija profile image
WardijaWardija in reply to BobD

Interesting. So Bob, I'm on Aspirin 75mgs and was put on this after I had a small stroke back in 2018Then, the following year, I had a HA.

I had 3 stents inserted (was told I needed a quadruple bypass ) but surgeon refused to undertake it, as due to my other numerous conditions, including unstable, insulin dependent diabetes, and a whole lot of other related conditions, I was considered as being too high a risk. So he recommended the only other option; lifelong medication, Clopidogrel, Atorvastatin, Isotard, Omeprazole - the main players, along of course with the daily Aspirin.

Only a short while later, I was diagnosed as having congenital HCM, Hypertrophic Cardiomyopathy, and given a helpful statistical guide, as to how many years i had left on the planet ! Together of course with some more meds. Bisoporil. 10mgs.

Bringing up the rear, I was further diagnosed with Atrial Fibulation and

Vascular Dysfunction.

Even more meds. Rythmodan, a hefty 500mgs daily, but I'm still here, heart wise.

However, the good man "upstairs" seemingly decided that he wasn't quite finished with me yet and decided to pop a cherry on top of my tasteless, sugar-free cake.

At the end of the Covid epidemic, I was diagnosed with CKD Stage III, that's Chronic Kidney Disease, diabetic acquired, so yet another progressive disease to add to my resume.

Dyalysis may eventually be calling my name on a tri-weekly basis.

So my question is, should I really still be taking the Aspirin ? Your posting made me think. None of my consultants have ever suggested stopping it.

If I had to guess, I'd say, yes, continue to thin the blood, as the Omeprozole is doing double duty as I originally took it for Reflux Oesophagitis, and now it's protecting the stomach as well.

It's all a bit arbitrary really. I'm going to be taken out by one, or more of the above conditions, my money would be on Multi-Organ failure as that seems to cover most bases. Unless of course, I'm hit by a bus tomorrow. Famous last words.

But for now, I'm still here, ticking along nicely and counting my daily blessings 🙏

BobD profile image
BobDVolunteer in reply to WardijaWardija

Aspirin is common AFTER a stroke but not as prevention especially with patients who have AF.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to BobD

Hi

In my Stroke report it reads that I 'failed' the aspirin test!

The Dr said it takes more than one time test?

So I wasn't put on aspirin! We used to get baby aspirin with high BP meds in the 2000s.

But when BP went low I lost the aspirin and Metoprolol.

There is research at Radcliffe Research UK doing a survey of folks who take both aspirin and an anti-co.agulant.

cheri JOY. 75 (NZ)

Alphakiwi profile image
Alphakiwi in reply to JOY2THEWORLD49

So your saying that if we have low blood pressure the more likely we are to get a clot.So my pacemaker helps with stroke prevention

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Alphakiwi

Hi

No its the AF Irregular heart beat which can cause a clot and a stroke.

Blood clots are less likely to happen when the patient is on an anti-co-agulant.

Either Warfarin or the new ones.

With irregular heart beat is the problem whether rapid/controlled/low.

Of course your Pace Maker helps you to main a heart beat which is too low under 60 during the day.

Meds are there to control BP or control Heart Rate.

We can have this med to control or prevent risk and that to do something else.

As I've been told and I agree we are all CEOs to our health, Drs, Nurses, Specialists are working for us.

We all have some issues with meds so we have to try a different one. If we can't tolerate a group of them in your case 'blood thinners'. Have you tried having them on their own with fruit or juice, we need to try something different.

If you tolerate low dose aspirin that could help. Could is always the real truth. Nothing is at some risk.

I take the low dose PRADAXA with no side effects, I refuse Statins, I have Covid jabs but not Flu Jabs or Shingles, Pneumonia.

Its my life and I am CEO of it. Balance it and stay with it.

Don't go around in circles.

Cheri JOY. 75. (NZ)

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to WardijaWardija

Hi

I read that by taking 20mg Avorstatin have the same effect.

Also read that taking statins over the age of 60 (I think) is a wasted move.

Statins can cause skeleton pain. I read that 1 guy taking a high dose of statins couldn't walk after 2 years.

You don't tell us how high your cholesterol is and you take the bad figure and subtract the good cholesterol.

The least amount of meds is of course better.

cheri JOY. 75. (NZ)

Alphakiwi profile image
Alphakiwi in reply to JOY2THEWORLD49

Hi Joy. Mr Wong told me my heart is vergood health its my electrical system.I dont take statins and i have never had hi bp under normal circumstances

WardijaWardija profile image
WardijaWardija in reply to JOY2THEWORLD49

Hi.I noted your comments.

From which medical journals are the statin related/studies data from, and what year where they published ?

I'd like to read them.

I don't have any skeletal pains caused by taking the statins over the past 5 years.

I've never been made aware of any implications, of taking statins over the age of 60 due to lack of efficacy.

Quite the opposite in fact, especially for patients like myself whose already have had a stroke and/or HA, and aditionally with Diabetes.

Such patients in this category can/should take statins up till the age of 85, according to The British Medical Journal. The British Heart Foundation, goes on to say, that regardless of age, anyone who has had a stroke or heart attack, or both, should be taking a daily statin.

With regard to all the other issues, I'm really not overly concerned.

I have a great cardiac team at The John Radcliffe Hospital, in Oxford, looking after me.

It's one of the leading cardiac hospitals/ centres of excellence here in the UK.

I'm more than content to have my 2 cardiac conditions managed there.

In fact, I'm actually really fortunate to be looked after by the Oxford team, as they have some of the most eminent consultants and surgeons practicing there.

As an former medical professional myself, of over 35 years, I always undertake research into all of the medications, prescribed for me, prior to starting them.

The dosages, I leave to my consultants. and MDT's professional judgement.

My overall serum cholesterol/HDL level is 4.3

My Consultant is happy with the above.

If he's happy, I'm happy 🙂

There is not much more to add from my side on this seemingly controversial subject, which I'm sure will continue to run on and on.

Do take care 🙏

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to WardijaWardija

Hi

I follow the Radcliffe Research team.

I kept all research of interest but because memory has got too high I had to delete and delete.

But it remains in my head. But why 80 years you stop statins. Why any age I would question.

Stick with what you are 'happy' with that's all I will say.

cheri JOY.

Globe-J profile image
Globe-J

Hi,

Please note, reposes to aspirin are individual. In my case, a blood test confirmed a positive response. I.e. aspirin decreased blood platelets stickiness to a safer degree, offering a reasonable degree of protection you are seeking.

Interestingly, some individuals appear immune to this desired effect. Request a relevant blood test, comparing your clotting factor before and after taking aspirin. Consuming a large ginger root daily achieved 35% efficacy, compared to 100 mg of aspirin daily (my case). Again, ginger is well known for decreasing blood clotting.

I do not experience any of the possible side effects, working with your GP should ensure that you are safe too. My investigation suggests that taking low aspirin dosage is one of the safest prevention measures - for responsive individuals.

Needles to add, getting rid of the affliction (AF), as some of us managed could be your aim too.

Best of luck

J (-:

BenHall1 profile image
BenHall1

Hi,

Has your doctor, or any healthcare professional ever sat down with and fully explained the 5 anticoagulant options available to you, all their pro's and con's and guided you to a sensible decision, noting your pacemaker.

From your post you have tried 2 out of 5 .... I'd be starting to ask some serious questions and make this Doctor work for his/her fee !

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to BenHall1

Hi

Yes we are reminded that we are the CEO of our health and it is the nurses, drs, specialists, surgeons who work for us so together we approve or decline or take a middle ground when it comes to moving on.

cheri Joy. 75. (NZ)

opal11uk profile image
opal11uk

When first diagnosed I was 56 (now 80) and my cardio said she wouldn't put me on Warfarin because of all of the faffing about so prescribed 375 mg a day of Soluable Aspirin, a few months later I had a stroke but thankfully not too debilitating and I think I owe that to the Aspirin, however I guess if I had been put on Warfarin I wouldn't have had the stroke in the first place!

BenHall1 profile image
BenHall1 in reply to opal11uk

Professional medical and scientific wisdom today and back as far as the early 2000's, ( I'm unsure of precise dates ) would understand that aspirin is not successful in stroke prevention. Even earlier I suspect which is why Warfarin has been the get go. I rather think your educated guess about Warfarin is correct, had you been prescribed it in the beginning you'd never have had the stroke. 😢

Alphakiwi profile image
Alphakiwi in reply to BenHall1

I was put on warfarin to start with in order to shock me back into sinus rythm but they coulnt get me stable on it so was put on Rivaroxaban. That was 6 years ago.Now my body is rebelling on it. I was becoming nauseas nearly all night. I have taken my self off the rivaroxaban. They dont know what to do with me as now im left prone to stroke. Im on aspirin which is not real effective i know. The latest thing is back to warfarin but will i stay stable on it and all the tests grrr

WardijaWardija profile image
WardijaWardija in reply to Alphakiwi

Maybe discuss with your Cardiologist, Bisoprolol/Clopidogrel /Rythmodon I'm on them for Atrial Fibulation, as well as for blood pressure control.

You should definitely be on something

to help you...🙏

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to WardijaWardija

Hi

Can't work out your age. Saw your profile. Will you 'admit' your age as this can make a difference.

Avorastatin is a statin and it is debatable whether you need it or not. Research shows that cholesterol cannot be read and we all need it for our body needs.

I take it now and then but even on 10mg the big post injured toe throbs. Now after a right shoulder inner cuff repair throbs.

It is supposed to keep one lower in inflammation but I question it. Also above 20mg interfers with thyroxine.

cheri JOY. 75. (NZ)

WardijaWardija profile image
WardijaWardija in reply to JOY2THEWORLD49

Hi 🙂Sure, no problem - I'm 62.

I was prescribed and take Atorvastatin 80mgs daily, as I'm considered as being at high risk for further strokes.

Obviously I was started on a much lower dose 5 years ago, before my initial TIA, and it's gradually been increased over the years.

That said, go back 20 years, my GP of the time wanted me to start on Simvastation as my chlorestoral was too high. I felt it didn't suit me, so stopped taking it. 20 years later, had the TIA followed by HA.

Would that still of happened, had I stayed on the Simvastation?

possibly not.

Regarding Atorvastatin and inflammatory issues. Yes, the information is out there, that some specific statins can marginally assist in reducing the "effects of inflammation", Hmm I'm not convinced . .

I have Osteoarthritis in my fingers, can't say I've noticed any reduction, inflammation wise., whilst taking Atorvastatin. They remain swollen and hurt like hell.

Not helped by my having diabetic neuropathy in my hands and feet.

Neuropathic pain is notoriously difficult to manage, as it is not even responsive to controlled, prescription pain relief.

Even Tramadol doesn't touch it.

I'm unable to take the first line, anti- inflamatory treatment, namely, Naproxen anymore, as its toxic to the kidneys.

I also have a historical trauma induced, broken shoulder and detached humerus bone, waiting for reverse joint replacement surgery,

Again, no relief from the statins.

I'm in constant pain, worse at night.

I now take Tramadol as needed.

Fortunately, I don't have any

Thyroid issues.

I never thought I'd end up like this, in my early 60's . . . and psychologically, its been very detrimental to my mental health. On meds. for this too.

It seems like you've been through the mill too, over the years 😟. I'm sorry to have read of your difficulties.

Life can really suck sometimes !

Alphakiwi profile image
Alphakiwi in reply to JOY2THEWORLD49

Im 81. Mr Wong says my heart is in good health. I have a problem eith my electrical system and also 2 yrs ago ultra sound showed my left atrium is twice what it should be in volume about 74 mg. Ive always had difficulty with meds, now ive proved its the blood thinners that give me hell. Im not on any now. The pradaxa seemed to be worse than the Rivaroxaban. As soon as i stopped taking either i am not getting this terrible nausea. Told doc i cant hack it any longer. No sleep and sea sick all night. He put me on the asprin but nothing else could be offered. Hes not happy about my decision so i look for something else and meantime i have no nausea. Still have several nasty issues with a flutter though. I want to see Raewyn Fisher and will be trying to contact her tomorrow.

Ennasti profile image
Ennasti

Speak to your Dr. My husband’s EP has him only on aspirin. Each person has individual health care concerns and history.

pusillanimous profile image
pusillanimous

My sister was admitted to hospital for a gall bladder operation after being on the NHS waiting list for some time. When there, she was diagnosed with AF (not surprising as all 5 of we sisters have it). Anyhow, they could not get her HR down and cancelled the operation. They sent her home with a packet of Aspirins. Three months later she had a stroke, albeit a mild one. Her gall bladder operation was never rescheduled, and sadly she died a year later after a gall stone migrated from the bladder to the bile duct and became cancerous.

WardijaWardija profile image
WardijaWardija in reply to pusillanimous

That's shocking. I'm so sorry for your loss 🙏

OzJames profile image
OzJames

my cardiologist puts me on Apixiban when I go into AF and for a month afterwards then he changes and puts me on the low dose coated aspirin. My Chad score is 1 as I’m over 65. He’s not old school he’s about 50 and a Professor. I’ve questioned him on more than one occasion and he assured me it’s ok.

Alphakiwi profile image
Alphakiwi in reply to OzJames

Ive had AF long enough to know that it can start again anytime so if your not on anything then your stuffed they say. There are many walking around with AF and they dont know it Its called proxysmal AF. these are are so prone to stroke. You are in a way lucky because you are aware and can do something about it. I started off knowing i had something and it was AF which would come and go. Im now in permanent AF

ozziebob profile image
ozziebob in reply to OzJames

I remember your previous helpful contributions about PIP anticoagulation, but I can't remember you mentioning aspirin. Or else I missed it.🤔 But can I ask what is your prescribed daily dose of "low dose coated aspirin" during your non-apixaban days?

I just checked online, and "low dose coated aspirin" seems to be a dose of 81 mg? Yes?

Are there any exceptional reasons why this aspirin prescription only applies to you, and is not also worth considering for others using PIP anticoagulation?

bob

Alphakiwi profile image
Alphakiwi in reply to ozziebob

Its 100mg Bob. Ive only been on it a few days, given to me by a part time doctor. I was told yesterday at our hospital that it is virtuously useless as a suitable coagulant for us with AF. Where to from here us who have af but having such difficulty tolerating the available blood thinners. Warfarin they find they cant stablise me on. I have read somewhere there is a procedure that can done by keyhole surgery on the heart so that pills for this problem not necessary.

Alphakiwi profile image
Alphakiwi in reply to ozziebob

Its called LAAC. Left atrium closure, something like that. It stops a clot from leaving the heart. I suppose the blocked clot eventually dissolves ?

Alphakiwi profile image
Alphakiwi in reply to Alphakiwi

Just read about it. Its the Watchman device. It closes off an appendidge in the heart. The appendidge doesnt need to be there, it only had use during development probably much like appendics which we can live without.Wonder if anyone here has this ?

ozziebob profile image
ozziebob in reply to Alphakiwi

Thanks for your contribution, but OzJames 's situation is different to yours ... he is using PIP anticoagulation with the agreement of his Professor/Cardiologist ... and I was asking him about the dose of aspirin he was prescribed for those days he is not taking apixaban.

Re your situation, there is the atriclip to destroy the LAA, but I don't think this is done unless a full minimaze is also undertaken.

OzJames profile image
OzJames in reply to ozziebob

Hi Bob In Australia the small aspirins are 100mg which I take once a day. I’ve had a few episodes over the last 18 months and he doesn’t believe my AF is regular enough to commence full time apixiban. I guess once it’s more of a monthly or bimonthly thing I’ll be on permanent anticoags. Each time they have done a CV they have done a TOE and seen no clot forming. Once I’m 75 I will go onto them according to him all being well till then. He said I continue to be fit and healthy and exercise every day. After last CV start of February I’ve continued the low dose metoprolol about 10mg morning and night that’s about 1mg Bisoprolol equivalent which he says seems to be enough for me to tamp down the adrenaline spike we sometimes get that provokes AF on occasions. I also continued the Flecainide since my last CV. He prescribed 25mg morning and night but I’ve reduced that a bit to 20mg originally it was 50mg. At that level it dropped my HR into the 40’s. So we have tinkered with it and now my resting HR seems to be in the 55-60 range. I would still take Fkecanide as PIP when in AF to convert. He said it’s about keeping me out of AF as long as possible without affecting my QOL. I’ve chatted to his EP who’s happy to ablate and thinks I’m a good candidate however he said the success rate was around 70-75% at 1 year. I’m trying to see if the low dose drugs can give me a better result as well as not risk damaging my heart. Hope your going well Bob

Alphakiwi profile image
Alphakiwi in reply to OzJames

Fair enough reasoning James. Have the cosidered pacemaker for the low heart rate. Mine was going low so pm put in set at 60. Original idea was to knock out my av nodr 5 weeks after pm pit in. All the bust from nz

OzJames profile image
OzJames

yes I’ve been lucky as I’ve been aware when I flip into AF my resting HR normally Is around 60 and when in AF about 85 at rest… and I notice it… I guess being lean and exercising most days I can feel the difference. Bought an Apple Watch and it certainly notifies me when in AF

Alphakiwi profile image
Alphakiwi in reply to OzJames

Your doctor surely has an unconventional approach. Seriously he should not be having luck in the equation ??

You may also like...

Aspirin 'not best' for preventing strokes

suppose the question for those of us already on Warfarin is do we push to be put on the \\"newer...

Stroke prevention in AF

mental arithmetic told me that was too many so I changed it to minutes.. I have now found the...

Stroke Prevention Day

irregular heartbeat. If you’ve had a stroke, you should have been tested for AF as part of your...

New Blood Thinner for Stroke Prevention

Hi all, Some exciting news for those on Blood Thinners for AF. Abelacimab is a monoclonal...

Stroke prevention

that 60% of strokes are caused by AF. So are the blood thinners not working in some cases? It would...