Dr John Day regarding scepticism re CHADS VASc score July 25, 2018 01:37PM |
Registered: 5 years ago Posts: 128 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 25, 2018 02:05PM |
Registered: 10 years ago Posts: 1,748 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 25, 2018 02:55PM |
Admin Registered: 6 years ago Posts: 5,343 |
Quote
Elizabeth
Thanks for posting, good article, I could never understand why doctors put people on blood thinners when they have only a couple of short AF episodes a year.
Re: Dr John Day regarding scepticism re CHADS VASc score July 25, 2018 03:09PM |
Registered: 10 years ago Posts: 1,748 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 25, 2018 03:45PM |
Registered: 8 years ago Posts: 1,102 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 25, 2018 04:40PM |
Registered: 5 years ago Posts: 128 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 25, 2018 08:18PM |
Registered: 5 years ago Posts: 129 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 25, 2018 08:57PM |
Admin Registered: 6 years ago Posts: 5,343 |
Quote
Brian_og
I read his point that there are other *objective* methods. It's just that they are not the official ones. He's not even convinced CHADS VASc is better than the old one.
Re: Dr John Day regarding scepticism re CHADS VASc score July 25, 2018 09:49PM |
Registered: 11 years ago Posts: 4,222 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 03:14AM |
Registered: 11 years ago Posts: 615 |
Quote
Carey
Because people with afib are at higher risk of stroke regardless of whether they're actively in afib. A large percentage of strokes occur with no recent afib episodes.
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 07:46AM |
Registered: 5 years ago Posts: 128 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 09:19AM |
Registered: 6 years ago Posts: 18,881 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 11:02AM |
Admin Registered: 6 years ago Posts: 5,343 |
Quote
mwcf
Surely a lone PAFr only has a higher stroke risk during an episode and for maybe a week tops afterwards rather than in the weeks/months-long periods between episodes?
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 01:29PM |
Registered: 11 years ago Posts: 615 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 01:47PM |
Registered: 10 years ago Posts: 1,748 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 02:02PM |
Registered: 11 years ago Posts: 551 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 02:06PM |
Registered: 6 years ago Posts: 233 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 02:43PM |
Registered: 6 years ago Posts: 18,881 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 04:30PM |
Registered: 11 years ago Posts: 4,222 |
Quote
Stacey
1. ApoE4 (genotype) doubles your risk of ICH (Intra Cranial Hemorrhage)
2. Warfarin doubles anyone's risk of ICH
3. The combination of e4 and warfarin risk of ICH is much greater than additive
4. People who have E4 have much poorer outcomes and more frequent death from ICH than from stroke
5. ICH is much more dangerous and damaging than stroke
6. Afib increases the onset of Alzheimer's
So I am a bit in a panic mode. What is very disheartening is that, here in Minnesota, cardiologists and electrophysiologists seem to know nothing about apoe4. My Chad Score stroke risk is 2.2%. My ICH risk, with anticoagulation, is somewhere between 10% and 36%. Yet my doctors think one must charge ahead with anticoagulation.
Re: Dr John Day regarding scepticism re CHADS VASc score July 26, 2018 09:23PM |
Admin Registered: 6 years ago Posts: 5,343 |
Quote
colindo
Carey, you have to ask what causes a stroke to form in the first place. Right.
Fibrin causes the platlets to stick together and build up, Natto and nattokinase dissolves fibrin, problem solved..[/quote
Even though Japan is the world's largest consumer of nattokinase, ischemic stroke is the most prevalent cardiovascular disease in Japan.
I wish it were so simple as "problem solved."
Re: Dr John Day regarding scepticism re CHADS VASc score July 27, 2018 01:26AM |
Registered: 6 years ago Posts: 444 |
Quote
Carey
Even though Japan is the world's largest consumer of nattokinase, ischemic stroke is the most prevalent cardiovascular disease in Japan.
Re: Dr John Day regarding scepticism re CHADS VASc score July 27, 2018 03:47AM |
Registered: 11 years ago Posts: 615 |
Re: Dr John Day regarding scepticism re CHADS VASc score July 27, 2018 11:18AM |
Registered: 6 years ago Posts: 444 |
Quote
mwcf
March 29, 2017 - Intracranial Bleed Risk Compared for Apixaban, Warfarin in A-fib Patients
"Patients taking apixaban showed significantly less intracranial hemorrhage (0.33% per year) vs. patients taking warfarin (0.80% per year) no matter the type and location. Factors associated with higher intracranial hemorrhage risk included: enrollment in Asia or Latin America, older age, prior stroke/transient ischemic attack, and aspirin use at baseline.
"This highlights the clinical relevance of reducing ICH by using apixaban rather than warfarin and avoiding concomitant aspirin, especially in patients with older age," the authors concluded."
Re: Dr John Day regarding scepticism re CHADS VASc score July 27, 2018 12:17PM |
Registered: 11 years ago Posts: 4,222 |
Re: Dr John Day regarding scepticism re CHADS VASc score August 11, 2018 09:27PM |
Registered: 12 years ago Posts: 117 |
Quote
wolfpack
I like the article, but I wish he hadn't expressed things in percentages. 1% of what amount of time? Statistics suggest that TWO HOURS of sustained AF is enough for a clot to form. That, of course, will be dependent on the individual and his or her blood viscosity and tendency to coagulate. My takeaway from the article is that it argues well for a PIP approach using DOACs for paroxysmal AF patients. I can tell you that I have Eliquis in my medicine cabinet, and if I have an episode exceeding 2 hours I will take it. I'll also stop it 24 or 48 hours after the episode terminates. The one exception being that if I ever get cardioverted, I'll take if for the entire month following.
Re: Dr John Day regarding scepticism re CHADS VASc score August 11, 2018 10:50PM |
Registered: 6 years ago Posts: 819 |
Re: Dr John Day regarding scepticism re CHADS VASc score August 12, 2018 09:09PM |
Registered: 8 years ago Posts: 1,102 |
Quote
anneh
I was wondering about reducing my Eliquis dose to 2.5 bid from 5bid as I haven't had AF for over 6mths and was thinking perhaps doing the reduced dose (I am constantly fearful of brain bleed) along with fish oil etc and then taking full dose when in AF. anneh
I like the article, but I wish he hadn't expressed things in percentages. 1% of what amount of time? Statistics suggest that TWO HOURS of sustained AF is enough for a clot to form. That, of course, will be dependent on the individual and his or her blood viscosity and tendency to coagulate. My takeaway from the article is that it argues well for a PIP approach using DOACs for paroxysmal AF patients. I can tell you that I have Eliquis in my medicine cabinet, and if I have an episode exceeding 2 hours I will take it. I'll also stop it 24 or 48 hours after the episode terminates. The one exception being that if I ever get cardioverted, I'll take if for the entire month following.
Re: Dr John Day regarding scepticism re CHADS VASc score August 13, 2018 12:18AM |
Admin Registered: 6 years ago Posts: 5,343 |
Quote
anneh
(I am constantly fearful of brain bleed)
Re: Dr John Day regarding scepticism re CHADS VASc score August 26, 2018 02:34PM |
Registered: 12 years ago Posts: 117 |