Eliquis + aspirin?

so have been on Eliquis now since 2017 for AF. Last week cardiologist said my carotid artery ultrasound came back "moderately" blocked on one side and that I should add a baby aspirin daily I am shocked at the blockage as my diet is plant based, I am slim and walk daily and other than AF at 80yo (F) I am in excellent health. My cholesterol could be better (180) altho HDL/Triglycerides are good, LDL ok altho could be better. I have eliminated the avocados/nuts/oils from my diet and will get it rechecked in a few months. BUT my main concern is whether to take the aspirin...... Dr said to cut back Eliquis to 2.5mgs bid (which frankly is what I was already doing) and add the aspirin. I know this is not an AF question but would appreciate input on this situation. thnx

You're not in afib heavily, right? If not then your doctor's advice makes sense to me and I can't think of any reason why you shouldn't follow it. Aspirin is an anti-platelet drug, and if you've got plaque in your arteries, platelets are prone to attaching to those plaques and forming clots when they rupture. So aspirin will help prevent that.

Eliquis, on the other hand, prevents a different kind of clot, the kind that forms spontaneously when blood pools and doesn't flow well. What your doc is suggesting is a compromise between the two. The aspirin is to protect against the first kind of clots forming, and the Eliquis is to protect against the second kind.

Why eliminate avocados/nuts/oils (as long as they are natural/cold pressed and not rancid bearing omega3 to 6 ratio in mind as well)
Have you checked your glucose tolerance at least your first phase insulin response???

thnx Carey, so it won't put me in double danger of internal/brain bleed etc? I have also read that it actually only takes 40mg aspirin to thin blood and recommendations to only take baby aspirin every other day?

Joe, my total cholesterol went up to 180 after adding 1/2 avocado daily and eating more nuts and believing all the hype that good fats are good for us. Seems altho they are good they also are loaded with saturated fats. So for now will eliminate and get cholesterol checked in a few months to see if it helped. My diet is clean otherwise. Just curious re your comment about glucose tolerance, so far always good.

Total cholesterol is relatively meaningless. Glucose tolerance without checking insulin response over a few hours can be misleading.
Anyway, just my 2 cents.

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anneh
thnx Carey, so it won't put me in double danger of internal/brain bleed etc? I have also read that it actually only takes 40mg aspirin to thin blood and recommendations to only take baby aspirin every other day?

No, it doesn't double your risks of a bleed.

What your doctor has recommended makes a lot of sense for you. They reduced your Eliquis dose and then added low-dose aspirin to protect against the other kind of clot I described above. The idea is to protect you from two threats without increasing your risk of bleeding. I think you're in good hands.



Edited 1 time(s). Last edit at 12/19/2019 11:35AM by Carey.

I see, so is there a relationship between glucose tolerance and clogged arteries?

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Joe
Total cholesterol is relatively meaningless. Glucose tolerance without checking insulin response over a few hours can be misleading.
Anyway, just my 2 cents.

thnx for your input, will not be as concerned about it now

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Carey

thnx Carey, so it won't put me in double danger of internal/brain bleed etc? I have also read that it actually only takes 40mg aspirin to thin blood and recommendations to only take baby aspirin every other day?

No, it doesn't double your risks of a bleed.

What you're doctor has recommended makes a lot of sense for you. They reduced your Eliquis dose and then added low-dose aspirin to protect against the other kind of clot I described above. The idea is to protect you from two threats without increasing your risk of bleeding. I think you're in good hands.

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anneh
I see, so is there a relationship between glucose tolerance and clogged arteries?
Total cholesterol is relatively meaningless. Glucose tolerance without checking insulin response over a few hours can be misleading.
Anyway, just my 2 cents.

Dr Bernstein says so unless i completely misunderstood what he says in his book. Best check for yourself, it's also an interesting read (at least if you are a bit nerdy like me)
He has been a diabetic since he was 12. Began studying medicine (after working as an engineer) at 45. He is still practicing in his 80s - somehow makes me think that he knows his subject first hand.

Carey will it be ok to continue my fish oil capsules, I hope so

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anneh
thnx for your input, will not be as concerned about it now


thnx Carey, so it won't put me in double danger of internal/brain bleed etc? I have also read that it actually only takes 40mg aspirin to thin blood and recommendations to only take baby aspirin every other day?

No, it doesn't double your risks of a bleed.

What you're doctor has recommended makes a lot of sense for you. They reduced your Eliquis dose and then added low-dose aspirin to protect against the other kind of clot I described above. The idea is to protect you from two threats without increasing your risk of bleeding. I think you're in good hands.

Quote
anneh
Carey will it be ok to continue my fish oil capsules, I hope so

Not a problem. Their blood thinning effect is minor and personally I've been taking them for years with warfarin, Pradaxa, and Eliquis. I've never had any doctor voice a concern about them. I mean, really, fish oil supplements in reasonable quantity are no different from eating a typical Japanese, Mediterranean or Nordic diet and those people take anticoagulants too.

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Carey

Carey will it be ok to continue my fish oil capsules, I hope so

Not a problem. Their blood thinning effect is minor and personally I've been taking them for years with warfarin, Pradaxa, and Eliquis. I've never had any doctor voice a concern about them. I mean, really, fish oil supplements in reasonable quantity are no different from eating a typical Japanese, Mediterranean or Nordic diet and those people take anticoagulants too.

In fact at my last appointment with my EP she actually prescribed fish oil capsules. I asked “what about Eliquis? “And she said, no problem for the reasons Carey mentioned above.