ESC: Anti-coagulation merely "to be considered" with CHA2DS2-VASc score of 1 in men or 2 in women

I'm sure this is has been discussed here before since it dates to August 2020. But I am happy to see that the ESC (European Society of Cardiology), in its updated 2020 Guidelines for the treatment of AF, is continuing with its previous guideline that oral anti-coagulation is simply "to be considered in patients with a CHA2DS2-VASc score of 1 in men or 2 in women, with treatment individualized based on net clinical benefit and patient values/preferences."

The ESC does not actually "recommend" anti-coagulation until patients climb one notch higher on the CHA2DS2-VASc scale, giving the patient at least one cardiovascular comorbidity.

The ESC 2020 guideline is Item 4 in this document summarizing the key points of the new guidelines: [www.acc.org]

This is significant and validating for those of us who are CHA2DS2-VASc 1 in men or 2 in women, and who are choosing not to take OAC (or in my case, not take any pharmaceuticals at all).

In Canada & US, the guidelines recommend anti-coagulation at the lower CHA2DS2-VASc score of 1 in men or 2 in women, And cardiologists in Canada & US seem to tell us with much hysteria that we could stroke out at any moment if we don't take these drugs. Yet their European colleagues do not agree.

PS... How do I add bold or italics to text with the new interface?

"PS... How do I add bold or italics to text with the new interface?"

I think they are having an issue, this is should not be the interface all the time going forward.

As my AF burden is very low, I don't personally see a reason for anti-coagulation and my 1 point is due age.

PoetKim,

Do some research on Nattokinase.
I take nattokinase for blood thinning.
This is one link to get you started.
[www.ncbi.nlm.nih.gov]

You may also be interested in Natto.
It's a miracle food.

[draxe.com]

[www.nyrture.com]

Natto and vitamin D has cured my monthly afib.

Thanks for the links and info, colindo. I have purchased nattokinase but have not started taking it. Have been meaning to do more reading on it so this will get me started.

And I bought some natto in those little frozen packs from Japan. I am going to give it another go.

Can I ask you how much natto and Vitamin D you take daily? (Although I realize we are all different.)

kim

Quote
PoetKim
In Canada & US, the guidelines recommend anti-coagulation at the lower CHA2DS2-VASc score of 1 in men or 2 in women, And cardiologists in Canada & US seem to tell us with much hysteria that we could stroke out at any moment if we don't take these drugs. Yet their European colleagues do not agree.

PS... How do I add bold or italics to text with the new interface?

I'm not sure about Canadian doctors but American doctors generally follow ACC guidelines, and those guidelines were updated in 2019 to reflect what you're saying. A CHADS 1 patient (up to 2 if female) won't generally be placed on anticoagulants unless they've recently undergone a procedure or there are other reasons specific to the patient.

You can add bold and italics by simply selecting the text you want to highlight and clicking the appropriate button above the message composition box. Inserting quotes and links, changing fonts, and so forth are accomplished the same way. These features were broken for the last couple of days but should be working now.

Quote
PoetKim
Thanks for the links and info, colindo. I have purchased nattokinase but have not started taking it. Have been meaning to do more reading on it so this will get me started.

And I bought some natto in those little frozen packs from Japan. I am going to give it another go.

Can I ask you how much natto and Vitamin D you take daily? (Although I realize we are all different.)

kim

I take two capsule of nattokinase, one first thing in the morning and one last thing at night. I use this brand [arthurandrew.com]
Which you can get from iherb.

I have one of the frozen packs of Natto every 2nd day for breakfast and take one 5000IU of vitamin D every 2nd non natto day.
I had a vitamin D test and the results indicated I was almost deficient, I started taking 10000IU a day but found that was too much for me, hence cutting it back to 5000IU every 2nd day. In the peak of summer I reduce the Vit.D to one a week.
I have been taking this protocol for almost three years and my monthly afib (sometimes 2 and 3 events a month) has slowly reduce to one event in the last 12 months.
The thing is, it is not a quick fix, well for me is wasn't.
I hope that helps.



Edited 1 time(s). Last edit at 02/06/2021 02:27PM by colindo.

Quote
Carey
I'm not sure about Canadian doctors but American doctors generally follow ACC guidelines, and those guidelines were updated in 2019 to reflect what you're saying. A CHADS 1 patient (up to 2 if female) won't generally be placed on anticoagulants unless they've recently undergone a procedure or there are other reasons specific to the patient.

Thank Carey. Canada does not seem to be on the same page with US and ESC then. Because I am very much berated and told I will die or am being crazy/stupid/suicidal by all cardiologists as well as ER staff for my choice to decline anti-coagulants at this time with my score of 2, no cardiovascular comorbidities, no family history of stroke, etc.

It is interesting to me to see that US now in line with ESC on this. I didn't know that.

Quote
colindo
I take two capsule of nattokinase, one first thing in the morning and one last thing at night. I use this brand [arthurandrew.com]
Which you can get from iherb.

I have one of the frozen packs of Natto every 2nd day for breakfast and take one 5000IU of vitamin D every 2nd non natto day.
I had a vitamin D test and the results indicated I was almost deficient, I started taking 10000IU a day but found that was too much for me, hence cutting it back to 5000IU every 2nd day. In the peak of summer I reduce the Vit.D to one a week.
I have been taking this protocol for almost three years and my monthly afib (sometimes 2 and 3 events a month) has slowly reduce to one event in the last 12 months.
The thing is, it is not a quick fix, well for me is wasn't.
I hope that helps.

Thank you. Wow! That is am impressive result! I have been wanting to add natto and/or nattokinase to my life. Plus D3. Am getting a Vit D test next week to know my baseline level without supplementation, and will start after that.

My electrocardiologist at Duke---a physician who is brilliant, trained with Natale, has performed 1000s of ablations, and is more than up to date on current research (and participating in some at Duke) also strongly advises me to take Eliquis, despite the fact that I was in Afib 4 times last year for less than a total of 20 hours, because I am 69 and a female. I am fit (e.g., tennis at least 4 times a week, walking my English Setter at least 2 miles a day) without any co-morbid conditions. He explained that everyone with Afib has an increased risk of stroking--not just an ischemic stroke from a blood clot thrown in fib, but in general. He said we have a 2 percent chance versus the general population having less than 1 percent, which over time adds up. Clearly a stroke is worse than Eliquis. He also thinks women clot more easily than men due to their need for this after childbirth and periods. Interesting point.

I have had two starts of Eliquis but a new puppy put the end to trial one in October 2020 with too many bites and scratches and I tried again in January after a 3 hours in Afib but given I am very physically active, I found giving up any NSAID or Tumeric was causing me enough pain and discomfort it was not worth it yet.

Comforted a bit by this European advice.

Who is your Dr. at Duke?

Tristram Bahnson, MD

He performed two Afib ablations with my husband and one flutter and thankfully, he has been Afib free for over ten years.