Stopped Eliquis - with some trepidation

I had a colonoscopy last week, so needed to stop Eliquis for a few days before hand. I have wanted to stop it altogether, at the encouragement of both my cardiologist and my PCP. My history includes10 years of Afib which ceased in 2013 with a LAA ablation by Dr. Natale, followed with a flutter ablation in June 2014.

I've had no Afib now for almost 11 years, and also got the Watchman implanted by Dr. Natale 2 years ago (he also checked how things held up from his 2014 ablation and all was great).

Two ablations, and a Watchman all done by the maestro, Dr. Natale, and NO Afib for almost 11 years. That's why my cardiologist thinks I should be off of Eliquis. I know Dr. Natale has encouraged me to stay on it anyway...but honestly, I don't see a good reason. Could I still get a non-Afib related stroke? I could...and so could anyone
who is over a certain age (I'm a healthy and active 72)....if it's to help avoid a stroke overall, then shouldn't everyone over age 65 or 70 be on it? That is not the recommendation, so that's why I am likely staying off of it. I just wish Dr. Natale was more encouraging about that too.

My take on it, as a Canadian who also has medical insurance as a veteran, and therefore who does not pay more than a few dollars for a 5 month supply of apixaban, is that it is cheap insurance against strokes.....OF ANY ORIGIN. The LAA and other sources of clotting all have the same mechanism, and all can be reduced considerably by apixaban or rivaroxaban. I sit a lot, even though I'm active otherwise, and as I age, deep vein thrombosis is going to become a real threat to me. The aged are already advised to wear support hose or similar on long flights for that very reason.

So, I have elected to just grit my teeth and continue to take it for its prophylactic effect....I hope. At some point, when falls and other calamities become more risky for bleeds than a stroke presents, say when I'm 85 or so, I'll probably elect to forego the apixaban.

Hi Tobhead
For what’s it’s worth as a physician ( not a cardiologist) I have learned personally to monitor my EKGs every day 3-4 times( 30 seconds a total of 2 minutes a day). I converted my AF of 2 yrs ( long standing persistent ) to SR for 18 months with my protocol and I never stopped monitoring it to pick up a rare recurrence of AF that were asymptomatic.I AF recurrences without symptoms occurred due dehydration, reducing a Mg dose, and when I had a fever with bronchitis. I never understood why self monitoring EKGs daily 3-4 times ia day is not a routine recommendation by EPs. I believe for those who are or were symptomatic if they detect asymptomatic AF if it was me I would remain on Eliquis,. I consider self monitoring EKGs no different than a diabetic sticking their finger to measure blood glucose daily or more. I will continue self monitori EKGs every day regardless of being in SR because the chronic inflammation causing AF may continue and AF could credit asymptomatically.

What's your CHADS-Vasc score? You can't make this decision or even talk about it without knowing that.

I'm in a very similar situation: Been in NSR since 2017, had a Watchman implanted in 2018, and on Natale's advice and my local EP and PCP's concurrence, I remain on half-dose Eliquis today and can't see any reason to ever discontinue it.

My cardiologist and my PCP believe the risk is greater for a bleed, being on a blood thinner, than the risk of me having a stroke. I know there are quite a few things that can be done naturally to help thin the blood, including taking nattokinase, Omega 3's (which have many positive benefits), garlic, gingko biloba and more.

My Chad score is 2, which would be 1 if I weren't female. (and I thought some docs were not using that factor anymore).

My "why" for wanting to get off of Eliquis is for the risk of a bleed, should I fall, etc., the need to be careful with taking things like Advil, Omega 3's, lowering the number of meds I'm taking, etc.

Again, I have the Watchman, whose whole purpose is supposed to be to let people get off their blood thinners, isn't it?

I deliberately got a watchman because of a nasty GI bleed and I needed a colonoscopy. Dr Natale allowed me 5 days off of Eliquis for the procedure and then to reduce my Eliquis to 2.5 BID for life.

My situation is different than yours. I still get afib —unfortunately all my three afib ablations failed and I’m a chads 5 on watchman report—and a chads 6 (female?) on the Medicare report. Congrats on your score 1.

Unfortunately I recently got my second DVT, one 2.5cm clot while on half dose 2.5mg BID so I’m forced by my hematologist to resume 5mg. I got two recent nasty bad nosebleeds three days apart that lowered my hemoglobin from 13 something to 9.9 in one week so I went back to 2.5mg until my hemoglobin increased to 10.4, then I resumed the 5mg and got my third nosebleed. My hemoglobin dropped a little on full dose recently. I’m trying to get pre authorization for iron infusions because my ferritin dropped in two years from 100 to 87 to 54 to 34 without infusions. I need to find the source of my bleed. My latest colonoscopy last year seemed normal.

I personally think full dose Eliquis is the culprit but I don’t want another DVT. I bleed more at the blood draw site after labs while on 5 but I barely bleed when taking 2.5.

My second dvt was found May 2024 under my armpit on the side I sleep on, my first in 1997 after a 18 hour flight on my leg which I thought was a fluke and I ignored it without daily aspirin but instead wearing dvt stockings and plenty of walking during flights.

I was always an Eliquis fan because in comparison it’s better than shooting up my stomach twice a day to dissolve my clot but these recent bleeds while on 5mg Eliquis are changing my views.

Ps I recently changed Eliquis manufacturers so maybe that is the reason for my bleeds. I’m very drug sensitive.

I return to my broken record. You have no data determining if u are experiencing asymptomatic AF without self monitoring your EKGs as I described.In my opinion if it was me I would need assurance that i do not have asymptomatic AF for many years before coming off Eliquis. Your EP recommendation appears to support the need for Eliquis. Why don’t u ask him why he recommended staying on Eliquis?

Hugging - please see my updated post about this. And don't forget, even if I DID have asymptomatic Afib, I have the Watchman. To note, my Afib was always very symptomatic.

I had a LAA closure after a MINI Maze procedure 17 years ago, when this notion was still fairly new. Over the years I have had this discussion with Cardiologists and EP's should I be on a NOAC or not. Keep in mind that there were no NOAC's back then and being on Warfarin was daunting.

In my last discussion with the professionals is that since I have a surgical closure and it is still valid and no leaks (which it is according to my latest CT scan). No need to be on a blood thinner, I can take a low dose aspirin a few days a week, low dose Eliquis, or nothing. Personal decision. I asked about Chad Vas score as a factor, in my case not so much. I am 75. I am also of the opinion that if everyone over 60 did the Chad Vas, everyone should be on a blood thinner.