Update on my recent post about stopping Eliquis - with trepidation

So I had written that I had some trepidation about stopping Eliquis, as I wasn't sure that Dr. Natale was on board with that idea. He did both of my ablations, and then sealed up my LAA with a Watchman, put in January 2022.

I have had no Afib for almost 11 years, was on a low dose of Eliquis as an extra precaution, but wanted to get off of it to reduce the number of meds I'm taking, reduce the likelihood of a bleed, and not to worry about taking some Advil for pain or too much Omega 3's, etc.

I finally reached his nurse, Maria, today. She heard my history with this, and said that as long as I had TEE's done 3 and then 6 months after the Watchman was put in (and I did), I can go off of it. He often likes to put people on aspirin every other day after that, but I will continue taking more natural things to help keep my blood "slippery" so to speak. I am a health coach and know quite a bit about supplements and cardio health in general.

The one thing she said I could do is get another TEE in 6 months after stopping Eliquis, to see how everything looks (no clots, etc), so I will plan to do that just to be thorough.

Both my cardiologist and PCP have been questioning why I was still taking a blood thinner when I have no Afib, and have a well seated Watchman (confirmed in the 2 TEE's) - and now I won't be.

Just thought I'd share this as it's a frequent topic ~ Barb

“Both my cardiologist and PCP have been questioning why I was still taking a blood thinner when I have no Afib, and have a well seated Watchman (confirmed in the 2 TEE's) - and now I won't be.”

Probably because your chads score is 1. If it was higher like 5, I speculate you might have had a different advice from his office.

Not sure. They never asked for my Chad score. I think it had more to do with no Afib for 11 years, and having a Watchman that has been checked twice for any issues after it was put in.

They never asked for your CHADS score because they're doctors capable of calculating it themselves. A CHADS-Vasc score of 1 makes it a judgement call. It's not clearance to stop the Eliquis and it's not a clear indication to continue it either. If you feel comfortable stopping it rather than compromising with something like a half-dose, then I think you should do what you feel is right. I just know that for me personally, based on my experience in the medical world, stroke is the worst possible outcome from any decision. Unlike most other maladies, death isn't the worst case scenario with stroke.

Since Dr. Natale's office is comfortable saying I can go off of it, as is my cardiologist who surely knows all about strokes, I'm OK with it too. I'm can understand why your experience of being an EMT makes you more hesitant, Carey, but everything is a bit of a risk as we get older, in my opinion. You could have a hemorrhagic stroke from Eliquis too...
If the feeling was that just getting older means you should be on Eliquis as a precaution, then everyone over a certain age would be put on it, yes? I do know that keeping your blood sugar in check, having low inflammation, and taking things that help keep your blood from easily clotting are all helpful in preventing any cardiovascular event, and I will be sure to do that.

I think it's worth a conversation with your cardiologist, especially if you're still on Eliquis, have had successful ablation(s), a Watchman, TEE's to check for any clots, leakages, etc. and all is good.

I don't want to hijack the thread but this refers to Carey's response. I just saw my Cardiologist and my CHADS-2 score is a one for being over 65. My BMI is 20, I eat a Mediterranean diet and exercise daily. I told him I have no problem being on one if he recommended it. He said "If it were me, I would not be on it." Maybe he was looking at my overall health?

Anyway, I like Carey's approach of a 1/2 a dose. I guess it would make sense with a CHADS equal to one? However, anybody know of any studies that show any benefit from a 1/2 dose?

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tobherd
Since Dr. Natale's office is comfortable saying I can go off of it, as is my cardiologist who surely knows all about strokes, I'm OK with it too. I'm can understand why your experience of being an EMT makes you more hesitant, Carey, but everything is a bit of a risk as we get older, in my opinion. You could have a hemorrhagic stroke from Eliquis too...
If the feeling was that just getting older means you should be on Eliquis as a precaution, then everyone over a certain age would be put on it, yes? I do know that keeping your blood sugar in check, having low inflammation, and taking things that help keep your blood from easily clotting are all helpful in preventing any cardiovascular event, and I will be sure to do that.

I think it's worth a conversation with your cardiologist, especially if you're still on Eliquis, have had successful ablation(s), a Watchman, TEE's to check for any clots, leakages, etc. and all is good.

As Carey mentioned, a stroke is worst than death. My father had 12 strokes and was a vegetable. It takes its toll on all family members.

Personally I would take the advice from Dr N and not his NP. He knows more and treats each patient individually.

Here is a recent article:
[www.diseasefix.com]

5mg is better for deep vein thrombosis.

2.5mg BID didn’t stop my DVT from growing to 2.5cm. As George mentioned, it doesn’t stop Dvt from growing.

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sldabrowski
Here is a recent article:
[www.diseasefix.com]

On the other hand, there's this article:

[www.tctmd.com]

Which quotes two of the principals of the ARISTOTLE study cited by the DiseaseFix article.

I think it's a worthwhile read, the bottom line of which is to work closely with your heart docs -- cardiology and EP -- so they can help inform the particular risks and rewards applicable to you.

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MikeN
However, anybody know of any studies that show any benefit from a 1/2 dose?

They would have to have conducted trials to prove a 1/2 dose is effective in order to get the 1/2 dose tablet FDA approved.

Susan - that IS the advice from Dr. Natale that she relayed to me.