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Apixaban and Age

bigbearatthecave profile image
21 Replies

In the AF Association leaflet it says you should only consider age as a factor as over 75. I have had no other factors other than having permanent AF and now I am 65 so a CHAD of 1

So should I be on it or not ?

Also, my Doctors do not check my AF they just say if it gets worse come in - are other Doctors more proactive than ours?

Thank you for all your replies to date.

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bigbearatthecave profile image
bigbearatthecave
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21 Replies
CDreamer profile image
CDreamer

Most people of 65 with CHADS of 1 and in permanent AF would be advised to take anticoagulants by a cardiac specialist in the UK, I would have thought, mine certainly did. Have you ever had a referral to an arrythmia specialist? By ‘doctors’ do you mean your GP? Where in the world do you live?

I would say that GPs are not always informed or proactive about AF and sometimes it will also depend upon how proactive you are about asking and some will leave it to patient to choose.

BenHall1 profile image
BenHall1

Hi,

I suppose another way of looking at the question .... "So should I be on it or not ?" is to consider family history.

If you have a family history ( on either or both sides ) of cardiac issues and strokes going back - say - to the 1960's or cardiac issues that have never been accurately identified or causes of strokes not accurately identified then I'd disregard the AFA age 75 bit and go for anticoagulation - now, not later.

I was 65 when AF mugged me, although, I suspect it might have been around some years earlier. It is a fact that in many folk an AF origin stroke can be fatal ..... that sort of stroke does not differentiate the age of a patient, 75, 61, 57, 45 or whatever. When I was first diagnosed it was my GP back in the day who sent me to A & E and they made the diagnosis. I do think for sure that that GP did know what was happening but wasn't prepared to put his head on the chopping block ! My current GP wouldn't know AF, of that I'm certain ........... in any event the modern GP is pretty useless at anything other than taking BP - in my personal view. You've got to get to see one first !

John

gtkelly profile image
gtkelly

Agree with BenHall. I was 64 when needed first cardioversion. This after GP sent me to A&E because of ecg result. Immediately put on apixiban and had cardioversion 6 weeks later. I had no other medical issues and was fit and slim. But in follow up with cardiologist some weeks after cardioversion he advised anticoagulant for life as my chad would automatically hit 1 on my next birthday. Now 68. Will never stop with the anticoag’s. Too high risk I believe of stroke.

BTW have had 2 further cardioversions in last 4 years. Currently all good.

OzJames profile image
OzJames

my cardiologist said my chad is 1 and I’m 66 but in NSR at the moment when I go into AF I’m to start the Apixiban and then for a month after I’m in sinus. If you’re in permanent AF I’m surprised they haven’t given you more direct advice. To me you should be on apixiban. I’m not a doctor so really can’t give advice just letting you know what I was told. And he also added that when I’m 75 we can review but most likely he will put me on full time apixiban

Morges profile image
Morges

Same here really. My GP did put me on Apixaban with my Chad of 1 and never suggested follow up or any lifestyle advice. She did refer me to cardiology for a follow up but they didn't want to know at all - they responded that she had put me on an anti coagulant - job done. I very rarely have any contact with my GP so far. Someone on this thread said the GP is only capable of taking a BP - I was not impressed when my GP took one reading - said that's a bit high here is a prescription - again no mention of follow up or lifestyle. I was very surprised because at home I had occasionally monitored my BP and it was not high. The monitor did pick up irregular heartbeat which prompted the GP appointment, which led to an ECG and diagnosis of left branch bundle block - told no need to worry and no treatment of followup necessary. I did a 24 hour BP monitor privately and the result was normal BP - never took the tablets. That was 3 years ago. The LBBB has morphed into AF picked up recently at a pre op assessment.I am now a sceptic on anything to do with doctors and dentists! If I get some proof that I have a problem I will comply.

But I do think anti coagulants for permanent AF is right, certainly for me - not worth the risk to not take. I also sorted out my own lifestyle - no alcohol/salt/sugar - although BMI was 25 those changes made a difference as I dropped a stone and BMI now 23.

Also worth getting an echocardiogram to see if there is a reason for AF - I paid £400 plus consultant fee for mine and I found it really helpful - and I have come to terms with taking anti coagulants. It is hard because I have always thought I was very healthy and fit etc. I was in denial but that echo and the consultation helped a lot.

ozziebob profile image
ozziebob in reply toMorges

I am shocked your AF was diagnosed in hospital and yet you had to pay £400 for an echocardiogram and consultation. No wonder you have lost faith in the system that once employed you.

Morges profile image
Morges in reply toozziebob

Ah to be fair that was my choice to bypass the NHS and go privately for that Echo...I needed a quick answer because my hip surgery was postponed until I got an ok to have surgery from a proper cardiologist. So I now have the ok and op on June 17 on the NHS.

ozziebob profile image
ozziebob in reply toMorges

I didn't really appreciate fully you were in hospital for a different procedure when AF was diagnosed, and it seems it was impossible or not urgent enough to include an echo at that time. Apologies if my comment was irrelevant to your situation. It's true I do have the luxury of not needing to use my elbows to obtain faster treatment than the NHS can provide, but perhaps it will be me one day. But I obviously hope not.🤞

Morges profile image
Morges in reply toozziebob

No worries - and thanks for responding to my posting . The NHS comes up trumps if there is an emergency or like my husband had a health scare (lung cancer but thankfully turned out to be something else) but all the stops were pulled out for him - no complaints there and credit given.

wischo profile image
wischo in reply toozziebob

Honestly? why would you wait for an eternity for an echo with the NHS when for £400 or less you can have it done privately plus a good review by a cardiologist. I know some people would find it difficult to pay £400 but most wouldent so as your health is your wealth it seems the most responsible thing to do.

ozziebob profile image
ozziebob in reply towischo

My comment wasn't directed at Morges personally, I was expressing consternation at the state of the overworked, under resourced and understaffed NHS.

wischo profile image
wischo in reply toozziebob

I never thought you were though its leaning towards having to pay for exploratory procedures all over at this time. The NHS is the place to go if you have a real emergency but if you need a scan or echo, stress test etc I think you will be waiting a fair amount of time for it. Hence my comment that for peace of mind and indeed possibly catching something in time, putting your mind at ease, etc a few hundred pounds seems insignificant for most people.

ozziebob profile image
ozziebob in reply towischo

Maybe I'm too frugal for my own good. Born into a family that struggled to avoid constant money concerns, and with an income affecting disability since childhood, I also watch my pennies. £400 is, to me, a lot of money. But good luck to those whose opportunities for resource accumulation have been more successful than mine. Perhaps £400 is no more than the price of a meal with friends to some.

bigbearatthecave profile image
bigbearatthecave

Thank you everyone, I live in Yarm in the North of England

Sixtychick profile image
Sixtychick

I was put onto anti-coagulants because I was over 65 which scores 1 point and female, which scores 1 point. Also there’s a family history of heart attacks and strokes. I have to stay on the Edoxaban for life, even though I had an ablation 7 months ago. I was worried about taking them, but so far, have not had much of a problem with excessive bleeding, even when having a tooth out, as I did a few months ago. I didn’t have to stop them for that. As I am under 60 kg, I only take 30 mg once a day. I think taking anticoagulants, is better than having a stroke or heart attack.

bigbearatthecave profile image
bigbearatthecave

Thank you everyone, the only thing i have noticed so far is my joints and muscles ache more and my sinus nasal drip has increased and more tired . Better than snuffing it I suppose

RoyMacDonald profile image
RoyMacDonald

A stroke is worse than snuffing it in my opinion. At least with snuffing it you don't know anything about it.

My Doctor is giving me a blood test to see if I need to be on a lower dose as I've reached the magic age of 80, but thinks it's a bit bizarre to change to a lower dose just because I've had a birthday. The consultant said to stay on the higher dose as long as possible. He did a blood test then when I was 76.

All the best.

Roy

Quilter43 profile image
Quilter43

I must have been in my 60s whenI started. Initially resisted but family history of heart attacks..strokes and af kept going higher so went on it.I just figure whatever can help best do it.

Buzby62 profile image
Buzby62

I took this screenshot for another post recently, for the benefit of any newbies reading the post, hope it’s helpful. Click on the screenshot to open up.

Best Wishes

CHA2DS2-VASc scoring
Chuyueling profile image
Chuyueling

I don't know about apixiban, but, no, mum's doctors are not proactive in the least. She is 75 and they don't check her AF at all (she's had it ten years and SVT before that, which they ablated) and haven't for years. She has had to be cardioverted in the past when it would.not go back into SR. I suppose they just wait until it is kicking off. She is happy with this arrangement, her kids less so :/ She is on edoxaban now with bisoprolol. Was warfarin prior to that. It doesn't feel that ideal that they don't check regularly but I haven been told unless you are in AF, or have bad symptoms, there's not much that can be gleaned from regular checks. Not sure I'm on board with that.

Sixtychick profile image
Sixtychick in reply toChuyueling

Every year, our GP surgery gives me a heart health check, with blood tests taken and BP checks etc. You don’t see a Doctor though, only a nurse.

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