For your doctors consultation, do not do anything on your own.
http://www.docguide.com/aspirin-still-overprescribed-stroke-prevention-atrial-fibrillation?
Aspirin is still overprescribed for stroke prevention in atrial
fibrillation (AF) despite the potential for dangerous side effects,
according to a study published in the American Journal of Medicine.“The
perception that aspirin is a safe and effective drug for preventing
strokes in AF needs to be dispelled,” said lead author Gregory Y.H. Lip,
MD, University of Birmingham, Birmingham, United Kingdom. “If anything,
you could say that giving aspirin to patients with AF is harmful
because it is minimally or not effective at stroke prevention, yet the
risk of major bleeding or intracranial haemorrhage is not significantly
different to well-managed oral anticoagulation.”
“All the contemporary guidelines say that aspirin should not be used
for the prevention of stroke in patients with AF,” he added”. And yet
our study shows that aspirin is still overprescribed in these patients.”
Prevention of strokes in patients with AF is based on identification
of risk factors. Patients with no stroke risk factors (ie, CHA2DS2-VASc
score of 0 in males or 1 in females) are considered low-risk and do not
need any antithrombotic drugs. Patients with 1 or more risk factors
should be offered effective stroke prevention, and thus be given an oral
anticoagulant. The use of aspirin, either alone or in combination with
an oral anticoagulant, is not recommended.
The study provides the most up-to-date picture of European
cardiologists’ prescribing of antithrombotic treatment, which includes
oral anticoagulation therapy (warfarin and the novel oral
anticoagulants) and antiplatelet drugs (mainly aspirin). The data are
from the EORP Atrial Fibrillation General Pilot Registry of more than
3,100 patients in 9 countries.
Overall the study found that the use of oral anticoagulants has
improved over the last decade since the last Euro Heart Survey was
performed. Where oral anticoagulation was used, most patients (72%) were
prescribed warfarin and just 8% were prescribed a new oral
anticoagulant.
“Novel oral anticoagulant uptake is still a bit low, probably because
of differences in regulatory approval, costs and access to drugs in
different countries,” said Dr. Lip. “But the main point is that overall
oral anticoagulant uptake as a whole has improved in the last 10 years.”
Aspirin was commonly prescribed, either alone or in combination with
an oral anticoagulant, when patients had myocardial infarction or
coronary artery disease. The strongest reason to prescribe both drugs
was coronary artery disease, which increased the use of combined therapy
by more than 8-fold.
“Aspirin is still overused for stroke prevention in AF,” said Dr.
Lip. “ESC guidelines say concomitant aspirin should not be given to
anticoagulated patients with AF with stable vascular disease. The
combination of drugs does not reduce cardiovascular events and stroke
but does increase the risk of bleeding.”
Another worrying finding was that oral anticoagulants were
under-prescribed in elderly patients, with aspirin alone more commonly
prescribed.
“Elderly patients are at the highest risk for stroke and yet they are
given aspirin which is not recommended and potentially harmful,” said
Dr. Lip. “There is a perception that elderly patients do not do well on
anticoagulation. But a number of studies now, including BAFTA, have
shown that in elderly patients warfarin is far superior to aspirin in
preventing stroke.”
Patients with paroxysmal AF were less likely to receive oral anticoagulation compared with patients with permanent AF.
“Cardiologists are continuing to under-prescribe anticoagulation in
paroxysmal AF and the belief that these patients are at less risk is
another myth,” said Dr. Lip. “ESC guidelines say that AF patients with
stroke risk factors should receive oral anticoagulation irrespective of
the type of AF. Our study of antithrombotic prescribing by cardiologists
reveals a positive trend of increasing oral anticoagulant use. But
worrying misconceptions and practices remain regarding aspirin,
treatment of the elderly and paroxysmal AF.”
SOURCE: European Society of Cardiology
Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 28,987 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke.DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER, BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.
What this blog is for:
My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.
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