The results of this study (http://www.medpagetoday.com/cardiology/arrhythmias/58683
), from the American College of Cardiology's PINNACLE Registry, are very concerning. Why would approximately 40% of afib patients who are at risk for a stroke (CHADS2 or CHA2DS2-VASc score greater than or equal to 2) still be getting just aspirin when we know that it does not work for preventing afib-related strokes, and in fact, causes bleeding?
In this registry, blood thinners (oral anticoagulants) were more common for those who were male (even though women have a higher stroke risk), had higher body mass, had a prior stroke (or TIA) or embolism, or had congestive heart failure. Aspirin was more common for those with high blood pressure, high cholesterol, coronary artery disease, prior heart attack, angina, recent bypass, or peripheral artery disease.
Apparently, the problems seem most likely to arise in those with other heart issues, but the guidelines make it clear that in some of those cases, such as stents, for those with a CHA2DS2-VASc score of 2 or greater, it is reasonable to use anticoagulants combined with clopidogrel, but without aspirin (Table 6, page e15 of the 2014 AHA/ACC/HRS Afib Guidelines). Thus, it is clear that doctors may need to become more aware of what to do in these special circumstances where the patient also has afib.
We in the afib patient community have to be super-educated to make sure we are having conversations with our doctors that ensure we are getting the right treatment to protect ourselves from strokes. That is why what I'm working on today is so critically important. I shouldn't be talking about it yet (I wasn't planning to say anything until I have all the details worked out), but I'm working with Dr. Elaine Hylek (one of the top experts in afib stroke prevention) to do a webinar in a few weeks about what afib patients need to know about blood thinners. We can educate ourselves and protect ourselves. I am fully committed to this - are you?
Mellanie**This blog post reflects the opinion of the author and does not necessarily reflect the opinions of the AHA**