Anticoagulants Increase Risk of Hemorrhagic-Type Strokes

Just read this info and find it frightening. In other words my Eliquis may help prevent an ischaemic stroke from afib but can cause me to have a hemorrhagic stroke according to Dr. M. Edip Gurol’s comments published in the March 18, 2018 issue Cardiac Rhythm News. A stroke neurologist specialist at Mass. General Hospital, he has a particular expertise in the care of patients at high risk for ischaemic (blockage type) strokes and haemorrhages If that wasn't enough the Washington Post health section recently confirmed what I have read before, anesthesia can definitely cause forms of dementia in elderly patients so me being 80 this year I presume that makes ablation not worth that risk. Frankly I wish I hadn't started on a NOAC and had stayed with my nattokinase/herbs/fish oils to help prevent a stroke. anneh

Anneh....I understand your concern about the risk of a hemorrhagic stroke while taking an anticoagulant....however, the risk that having a-fib for an ischaemic stroke is probably greater. As we have learned, different doctors have different opinions about almost all methods of treating a-fib. Taking an NOAC can significantly offer you protection against stroke as a result of having a-fib. I am about to have my 80th birthday also...and during my 70's had 3 ablations....the 3rd one was successful in that I've been in normal sinus rhythm for more than 3 1/2 years. I have not had any cognitive problems as a result of the anesthesia from the.ablations...but i suppose that would vary with each individual. I no longer take any rhythm or rate control medicines...but I continue to take Eliquis (which now has a reversal agent) and will continue to do so as a safeguard against stroke should the a-fib return (as is a possibility). I do not worry so much about a bleed. My doctor says you can replace blood...but you cannot replace brain....so that is why I will continue to take Eliquis....even though there may be a slight concern about a hemorrhagic stroke. I am glad to be protecting myself from a stroke that a-fib could cause.

Sorry to hear its too late for you. Thanks for the warning, Ill continue and take my chances with Natto and fish oil. The hasbled and hemorrhage risk cannot be denied. The question becomes for our condition, what is the risk and the odds for stroke if we refuse anticoags? Depending on which study you believe and realizing the ambiguity of them, IMO, its about 2% greater risk if I refuse. We all have to decide for ourselves based on our own situation.

Hello Anne - I can appreciate your apprehension about long-term use of Eliquis as I am ‘stuck’ on the half dose since the last ablation in 2015 and I agree that I’d rather be using the NK and Omega 3’s that worked for me so well for so long. Outside of eliminating afib, most important for avoiding future clot risk is recognizing contributing factors which typically involve the inflammatory process which you can monitor by lab tests to help reassure that you are not ‘harboring’ arterial inflammation.

If you haven’t read the previous posts on this topic… following are the links. Even though I’m on Eliquis, I still have those tests periodically and take small doses of the relevant nutrients recommended – especially for keeping the various markers in the normal ranges. While the Eliquis should work as advertised for lysing clots that might accumulate, I also want to manage any other potential contributing factors as well and my FM MD agrees.

Jackie


Viscosity Risk Factors

Silent Inflammation
[www.afibbers.org]

Sticky, thick blood - Risk of Stroke and MI
[www.afibbers.org]

Clot Risk
[www.afibbers.org]

Lumbrokinase for Clot Risk Prevention
[www.afibbers.org]

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Jackie
While the Eliquis should work as advertised for lysing clots that might accumulate.

Maybe....then again, it didn't work for me..and I could watch it not working for several months of TEE tests.
How much really works "as advertised' anyway?

PS Anyone ever seen a Warfarin advertisement on TV, or received boxes of free sample from your cardiologist or EP?
I've got at least 10 boxes of free samples of Eliquis...too bad I don't use them.



Edited 1 time(s). Last edit at 06/06/2018 01:25PM by jpeters.

It's important to understand that neither warfarin nor the NOACs lyse clots. Your body does that. All the anticoagulants do is prevent the clot from enlarging and new ones from forming. In that regard Eliquis has been demonstrated to be superior to warfarin. It's entirely possible that your clot would have resolved in the same amount of time had you remained on Eliquis. Impossible to know from a single experience.

The only drugs that actually lyse clots are the thrombolytics such as tPA, which is extremely expensive, can only be given IV, and is fairly high risk. Although there are some case reports of it being used to break up large atrial clots, that's not a common use.

Thanks Carey - that's interesting... because the literature says Eliquis is used to treat deep vein thrombosis and also treat of pulmonary embolism. I take that to mean it breaks down or lyses the clot.

Jackie

PS
What clot are you referencing as "my clot?"

Yes, the body breaks down the clot and anti-coagulent keeps new clots from forming. Unfortunately, Eliquis wasn't doing that over several months. We switched to Warfarin so we could actually monitor the INR. The clot was completely gone in two weeks. BTW/ this isn't anecdotal...it's a valid within subject repeated measures longitudinal study. I suspect at some point the one-size-fits-all marketing scam will end, and they will actually find ways to test the effectiveness of NOAC's on an individual basis. I recalled asking the cardiologist if he's even seen a case where the clot did not break down. He said no.

". It's entirely possible that your clot would have resolved in the same amount of time had you remained on Eliquis."
No it's not.



Edited 1 time(s). Last edit at 06/06/2018 09:16PM by jpeters.

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Jackie
What clot are you referencing as "my clot?"

Not sure what you mean. I don't think I ever referenced "my clot." I've only referred to jpeter's clot.

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jpeters
BTW/ this isn't anecdotal...it's a valid within subject repeated measures longitudinal study.

That's an impressively fancy way of saying anecdotal. One patient, one experience = anecdotal.

I'm not saying you're wrong. I'm only saying one person's experience with one incident offers nothing for the rest of us. The reasons why you experienced what you did could be many and we have no way of knowing what it was. The bulk of the evidence for the rest of us still comes down firmly in favor of Eliquis over warfarin.



Edited 1 time(s). Last edit at 06/07/2018 01:09AM by Carey.

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Carey

BTW/ this isn't anecdotal...it's a valid within subject repeated measures longitudinal study.

That's an impressively fancy way of saying anecdotal. One patient, one experience = anecdotal.

No, it's not, within subject designs are great when you don't have large sample groups. In this case, you get to accurately measure just how large the clot is initially, and how much it diminishes over three months by administering a series of TEEs. The result is, not much. Then you switch to a different medication, and measure again in a few weeks. It it's completely gone, you can assume to a p= .00001 that the change is the result of the new different medication.

To design a test like this would never pass human subjects review. The TEE would be far too risky in addition to expensive.The result only shows that Eliquis didn't work for me. However, I would postulate it's not working for other people either.

BTW/ if it did work for everybody, it would be the only medication I've every heard of that did. Generally, they work for about 1/3 of the people who take them, and then stop working after a certain period. Also, the dose needs to be varied across individuals. The advantage of NOAC's is that most people who use them aren't getting testing....in which case their reports can be dismissed as "anecdotal."



Edited 2 time(s). Last edit at 06/07/2018 01:09AM by jpeters.

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jpeters
It it's completely gone, you can assume to a p= .00001 that the change is the result of the new different medication.

That's an impressive level of certainty. Not sure how you got there but whatever. As I said, I'm not saying you're wrong. I'm just saying your experience can't be applied to the rest of us.

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Carey

It it's completely gone, you can assume to a p= .00001 that the change is the result of the new different medication.

That's an impressive level of certainty. Not sure how you got there but whatever. As I said, I'm not saying you're wrong. I'm just saying your experience can't be applied to the rest of us.

To go from sizeable clot over three months to zero in 2 weeks is a pretty impressive effect. I may be unique, but do share some commonality with others in my species