Anticoagulants

munroad
Posts: 44
Joined: 25 May 2009, 9:09am

Anticoagulants

Postby munroad » 11 Nov 2017, 9:14am

Am on rivaroxaban (anticoagulant) to reduce risk of stroke from paroxysmal atrial fibrillation. Slightly concerned about risk of bleeding in case of accident....ruptured spleen, sub dural haematoma, fractures etc. Probably just have to be careful!
See my post on risk reduction in On The Road.

softlips
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Joined: 12 Dec 2016, 8:51pm

Re: Anticoagulants

Postby softlips » 11 Nov 2017, 9:49am

Ask if you'd be allowed an LA appendage closure device?

munroad
Posts: 44
Joined: 25 May 2009, 9:09am

Re: Anticoagulants

Postby munroad » 11 Nov 2017, 10:38am

Crikey that’s high tech!
I had an ablation for flutter a year ago. My mother and both brothers had atrial fib. so I am at high risk of AF. Had an episode lasting one minute about one month ago (I have a Kardia ecg thingy on my phone) so it hasn’t been a problem to me yet.
On beta blocker too.

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Cunobelin
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Re: Anticoagulants

Postby Cunobelin » 11 Nov 2017, 10:44am

There will always be a risk with medications, and with anticoagulants the trick is to get the clotting at an optimum level

In Trauma, the bleeding becomes th greater risk and anticoagulants can be reversed quite quickly

This is well stablished as an intervention. Interestingly the new drugs like Rivaroxaban have a decreased mortality when compared with traditional anticoagulants such as Warfarin

munroad
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Joined: 25 May 2009, 9:09am

Re: Anticoagulants

Postby munroad » 11 Nov 2017, 11:04am

Rivaroxaban requres no blood test monitoring and as yet has no antidote to reverse it.

axel_knutt
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Re: Anticoagulants

Postby axel_knutt » 11 Nov 2017, 11:09am

As you appear to be aware, AF increases your risk of having an ischaemic stroke, and anticoagulation reduces the risk of an ischaemic stroke at the price of increasing the risk of a haemorrhagic stroke. Making an optimum decision therefore entails comparing the risk of each.

Your risk of ischaemic stroke is assessed using the CHA2DS2VASC scoring system, and that of haemorrhagic stroke using the HASBLED score, each score is calculated by allocating points to the answers to a series of health questions. You can then use the scores to look up the corresponding stroke risks. All is explained in the NICE Patient Decision Aid.

You may also be interested in the anticoagulation recommendations in the European Society of Cardiology Guidelines for the Management of AF.
“I'm not upset that you lied to me, I'm upset that from now on I can't believe you.”
― Friedrich Nietzsche

munroad
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Joined: 25 May 2009, 9:09am

Re: Anticoagulants

Postby munroad » 11 Nov 2017, 11:32am

Thanks AK.

Yes I am aware. I am actually a retired physician but worked in trauma surgery when young! Perhaps I know too much!
The advice I have had has been wear a helmet, don't fall off, don't do hairy off road biking. The 'don't fall off' advice has led me to put the post question on 'on the road' entitled 'staying safe'.
Mrs m not keen on me cycling at all!

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Cunobelin
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Re: Anticoagulants

Postby Cunobelin » 11 Nov 2017, 4:38pm

munroad wrote:Rivaroxaban requres no blood test monitoring and as yet has no antidote to reverse it.


The relevant phrase was "in trauma" in this case the anticoagulant effect WOULD be measured and assessed

There are also methods of reversing Rivarobaxan:

Prothrombin complex concentrate immediately and completely reverses the anticoagulant effect of rivaroxaban in healthy subjects


(Reversal of Rivaroxaban and Dabigatran by Prothrombin Complex Concentrate. A Randomized, Placebo-Controlled, Crossover Study in Healthy Subjects,Elise S. Eerenberg, Pieter W. Kamphuisen, Meertien K. Sijpkens, Joost C. Meijers, Harry R. Buller, Marcel Levi

munroad
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Joined: 25 May 2009, 9:09am

Re: Anticoagulants

Postby munroad » 12 Nov 2017, 8:38am

Thanks Cunobelin, That’s reassuring. I should have read your post properly!

ChrisButch
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Re: Anticoagulants

Postby ChrisButch » 3 Dec 2017, 3:50pm

Cunobelin wrote:There are also methods of reversing Rivarobaxan:

Prothrombin complex concentrate immediately and completely reverses the anticoagulant effect of rivaroxaban in healthy subjects


(Reversal of Rivaroxaban and Dabigatran by Prothrombin Complex Concentrate. A Randomized, Placebo-Controlled, Crossover Study in Healthy Subjects,Elise S. Eerenberg, Pieter W. Kamphuisen, Meertien K. Sijpkens, Joost C. Meijers, Harry R. Buller, Marcel Levi

When I was offered the choice between Rivarox. and Warfarin, I was told that the former requires hospital admission for reversal, whereas a Warfarin bleed can often be dealt with by the GP practice.