What do you think? Aspirin doubles risk of stroke/heart attack in afibbers

bouret

What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 02, 2018 03:14PM

Registered: 7 years ago
Posts: 3

Here is a link to the article. Now I am really confused thinking the new anticoags and aspirin were ok........

[nutritionreview.org]

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jpeters

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 02, 2018 03:28PM

Registered: 6 years ago
Posts: 444

"The study also found similar risks with the DOAC drugs. This new class of drugs doubled the risk of a heart attack."

Disclaimer: I haven't looked at the study

[www.ncbi.nlm.nih.gov]

Cohort study: DOAC's looked at included Xarelto and Pradaxa

Edited 2 time(s). Last edit at 09/02/2018 03:44PM by jpeters.

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daledint

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 02, 2018 04:10PM

Registered: 10 years ago
Posts: 10

See that Eliquis (apixaban) is safer ? wonder by how much?

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GeorgeN

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 02, 2018 05:21PM

Registered: 11 years ago
Posts: 4,220

Quote

The study showed that, among patients with AF, the risk of
AMI was doubled for current users of DOACs and aspirin vs.
current users of VKAs. The higher risk of AMI was also
significant for past users of aspirin vs. VKAs. After
stratification for gender, the risk remained significant only
for users of aspirin. After stratification for stroke risk by
CHA2DS2-VASc score, the risk of AMI remained significantly
increased for high risk (score ≥4) aspirin users and medium
risk (score >1 and <4) DOAC and aspirin users compared
with current users of VKAs.

Quote

In conclusion, our cohort study identified a twofold
increase in the risk of AMI when using DOACs, rivaroxaban
or dabigatran, in comparison with VKAs, in AF therapy in
real-world patients. In addition, our results showed that in
AF patients, the risk of AMI with current use of aspirin as
monotherapy is higher than with current use of VKAs. VKAs
probably have greater beneficial effects on AMI than DOACs.
Ongoing research is needed as the use of DOACs increases in
the population.

doi:10.1111/bcp.13264

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Carey

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 02, 2018 05:32PM

Admin
Registered: 6 years ago
Posts: 5,328

Sigh... relative risks. If your risk of something is .01% and you do something to double that risk, what's your risk now? It's .02%, of course, which is still utterly trivial. Relative risks are not good science. They're mostly a good way of taking boring results and making them sound dramatic, so I'm ignoring this study until I can see the actual data.

Edited 1 time(s). Last edit at 09/02/2018 05:56PM by Carey.

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jpeters

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 02, 2018 05:45PM

Registered: 6 years ago
Posts: 444

Got to love NutricianReview's comment on warfarin. I make regular visits for periodontal cleaning while on warfarin without gum bleeding.

"warfarin has many serious side effects such as severe bleeding or bleeding from the gums, intense headaches, stomach and joint pain, and vomiting blood." smiling smiley

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jpeters

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 02, 2018 06:38PM

Registered: 6 years ago
Posts: 444

Quote
Carey
Sigh... relative risks. If your risk of something is .01% and you do something to double that risk, what's your risk now? It's .02%, of course, which is still utterly trivial. Relative risks are not good science. They're mostly a good way of taking boring results and making them sound dramatic, so I'm ignoring this study until I can see the actual data.

What do you think the chances are of only 3 people having heart attack for a population of 30,146 afibers over a course of six years?

[www.cardiosmart.org]

Edited 1 time(s). Last edit at 09/02/2018 06:55PM by jpeters.

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GeorgeN

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 02, 2018 10:18PM

Registered: 11 years ago
Posts: 4,220

My interpretation (reading the whole paper) is that a) afib is associated with a higher heart attack risk (perhaps because many afibbers have comorbidities); b) warfarin is associated with a lower heart attack risk in afibbers (note that this effect is much lower in those with a CHADs2VASC score of 1 or less (because they don't have the comorbidities). I think it would be perhaps more accurate to say that warfarin provides a potential benefit that aspirin and DOACs do not. Not that aspirin or DOACs cause more heart attacks.

Edited 2 time(s). Last edit at 09/03/2018 09:25AM by GeorgeN.

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jpeters

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 03, 2018 12:08AM

Registered: 6 years ago
Posts: 444

Quote
GeorgeN
I think it would be perhaps more accurate to say that warfarin provides a potential benefit that aspirin and DOACs do not. Not that aspirin or DOACs cause more heart attacks.

Yes, the study is a comparison with warfarin. The title is confusing.

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smackman

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 03, 2018 07:21AM

Registered: 10 years ago
Posts: 836

Quote
Carey
Sigh... relative risks. If your risk of something is .01% and you do something to double that risk, what's your risk now? It's .02%, of course, which is still utterly trivial. Relative risks are not good science. They're mostly a good way of taking boring results and making them sound dramatic, so I'm ignoring this study until I can see the actual data.

Agree 100%. If we read every study about AFIB or Lochnest is Alive, Well I personally think much of it is a pile of CRAP.

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wolfpack

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 03, 2018 10:12PM

Registered: 8 years ago
Posts: 1,102

If you buy two lottery tickets, your “risk” of winning just doubled.

Go ahead and start spending the money. smiling smiley

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jpeters

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 04, 2018 12:51AM

Registered: 6 years ago
Posts: 444

Quote
wolfpack
If you buy two lottery tickets, your “risk” of winning just doubled.

Go ahead and start spending the money.

Then again, you're not laughing about all the marketing hype about how wonderful Eliquis is, right?

In the study I linked above in a population of 24,000 there were a total of 648 heart attacks over a seven year period. All were free of heart disease at the beginning. Those with afib had twice as many. Maybe that's funny?

"Based on these findings, authors conclude that heart attack is a serious health concern for patients with AFib. With an estimated 2.66 million Americans living with AFib, the impact of these findings is enormous"

Edited 3 time(s). Last edit at 09/04/2018 01:21AM by jpeters.

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Carey

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 04, 2018 09:30AM

Admin
Registered: 6 years ago
Posts: 5,328

Quote
jpeters
Then again, you're not laughing about all the marketing hype about how wonderful Eliquis is, right?

In the study I linked above in a population of 24,000 there were a total of 648 heart attacks over a seven year period. All were free of heart disease at the beginning. Those with afib had twice as many. Maybe that's funny?

What's your point? There is no established cause-effect relationship between afib and heart attack.

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jpeters

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 04, 2018 09:59AM

Registered: 6 years ago
Posts: 444

Quote
Carey

What's your point? There is no established cause-effect relationship between afib and heart attack.

!!!!!!!!!

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mwcf

Re: What do you think? Aspirin doubles risk of stroke/heart attack in afibbers
September 04, 2018 01:37PM

Registered: 11 years ago
Posts: 615

Agreed Carey. Can't see much cause and effect between AF in isolation and MI. Or put another way, it's the co-morbidities that so often accompany AF that predispose towards MI.

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