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blood thinner... article ?? blood test to determine risk??

Posted by bettylou4488 
blood thinner... article ?? blood test to determine risk??
March 10, 2019 10:52PM
EP appointment tomorrow.. doing a little light reading. I know web MD isn't the end all be all but found the following. I am wondering about the study that was referenced but also a blood test can be done to determine risk? Anyone know anything about that?

At three and five years, the rates of stroke, mini-stroke and major bleeding were higher with any blood thinner, compared with no treatment, the researchers found. The rates of these outcomes were lower among patients taking warfarin than among those taking aspirin or Plavix, the study authors added.



Horne said that Intermountain has developed a risk score using a blood test that can help doctors make a more precise decision about a patient's risk for stroke. When used along with the CHADS2 score, it might prevent low-risk patients from being put on a blood thinner, he said.

[www.webmd.com]
Re: blood thinner... article ?? blood test to determine risk??
March 11, 2019 04:52PM
Very interesting, I do think blood thinners are over prescribed, a person that has AF only a couple of times a year is put on blood thinners which is in my opinion over kill. How many doctors check your blood platelet count before prescribing a blood thinner? They didn't with me, I do have low blood platelets, not real low but right at the lower end or a little below the lab values. I believe doctors prescribe to be safe rather than sorry or be sued.

Liz
Re: blood thinner... article ?? blood test to determine risk??
March 11, 2019 06:55PM
I would be really skeptical of this article. First, there's a HUGE problem with it. The author doesn't actually reference the study he's talking about, so we can't read it for ourselves. For all we know the reporter misconstrued it, the study was shoddy, used very small sample size, used incorrect statistical methods -- there are all sorts of potential problems that we can't see for ourselves.

Second, you can't draw conclusions based on a single study. I'd want to see other studies confirm their results, especially their finding that anticoagulants increased stroke rates. Notice he doesn't say whether those were ischemic, hemorrhagic or both. If they were hemorrhagic then that falls under the heading of old news.

Third, notice that he says the stroke rates were lower among warfarin users than aspirin or Plavix. Again, old news. In fact, any EP prescribing aspirin or Plavix for afib is already in doubt. Neither one is recommended for stroke prevention in afib and hasn't been for some time now.

The question of when and if to put someone on anticoagulants is a difficult one. A CHADS-Vasc 0 usually shouldn't and most EPs wouldn't, but there are exceptions (a history of DVTs, for example). A CHADS-Vasc 1 is a clinical judgement based on the patient's particulars, and many also won't be put on them. Of course there are poor doctors out there, but the vast majority do their best for their patients and sincerely try to do what is best for their patients.

PS- You're quite right that WebMD isn't the end all, be all. But actually it's really quite worse than that. Things like this article, their poor journalistic standards, and the billions of ads on their site are why WebMD outright sucks. I wouldn't recommend even visiting the site.
Re: blood thinner... article ?? blood test to determine risk??
March 11, 2019 09:15PM
I agree with you Liz.

Of course there is always Natto (food) or Nattokinase for low risk, and it does a lot other good things besides.
check this link [articles.mercola.com]
This just one reference, there are plenty more.
Re: blood thinner... article ?? blood test to determine risk??
March 11, 2019 10:17PM
I just wanted to update you all that i had a very good discussion with the EP today about many things. ON the xeralto, he said.. it is up to me and he supported it either way and laid out what he felt the risks were. i am going to stay on it till i decide if i want to go off it. I am fairly young (52) so going to just think thru it. (I am a 1 2 or 3 depending on how you look at the numbers.)
Re: blood thinner... article ?? blood test to determine risk??
March 12, 2019 12:19AM
That sounds like a very reasonable doc and a good decision.

You can toss the point for being female, by the way. It's officially no longer counted in anticoagulation decisions. smiling smiley
Re: blood thinner... article ?? blood test to determine risk??
March 12, 2019 07:11AM
This is some info on the study referred to by op


[intermountainhealthcare.org]
Re: blood thinner... article ?? blood test to determine risk??
March 12, 2019 12:24PM
Quote
bettylou4488
I just wanted to update you all that i had a very good discussion with the EP today about many things. ON the xeralto, he said.. it is up to me and he supported it either way and laid out what he felt the risks were. i am going to stay on it till i decide if i want to go off it. I am fairly young (52) so going to just think thru it. (I am a 1 2 or 3 depending on how you look at the numbers.)

Thank you BettyLou for the update and I'm really curios what and how you will decide.
Re: blood thinner... article ?? blood test to determine risk??
March 12, 2019 12:44PM
I should add i have a zio patch on for 2 weeks and i am hoping this may help with my decision... if i have no afib then i may go off it. I'll keep ya posted smiling smiley
Re: blood thinner... article ?? blood test to determine risk??
March 12, 2019 07:53PM
Good find, Betty Lou. Thank you for this thread.

Agree with both Liz and Carey.

Puzzling: The article is almost two years old, and this is the first we're hearing about it? ...even though it was scheduled to be presented at the ACC's annual meeting in 2017? Don't get that at all. Of course, one of the first things that may come to mind these days is the "politics of healthcare." Who knows?

One little bit that I found interesting:

... "Conditions not in the score that can make people more prone to stroke include kidney dysfunction, obesity, smoking and alcohol use, and many others, Patel said."

So for those of us with a CHADS score of 1, knowing that we have none of the above, would tend to legitimately offer at least "some" qualitative comfort -- quantitative would be much better -- in not yet going on an anticoagulant.

/L
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