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posted by janrinok on Wednesday November 13 2019, @09:25PM   Printer-friendly
from the fun-of-growing-old dept.

Arthur T Knackerbracket has found the following story:

The net clinical benefit of anticoagulants for atrial fibrillation (AF) -- one of the most important causes of irregular heartbeats and a leading cause of stroke -- decreases with age, as the risk of death from other factors diminishes their benefit in older patients, according to a study led by researchers at UC San Francisco.

The multi-institutional study of nearly 15,000 AF patients found that the anticoagulant warfarin was not beneficial after age 87 and another, apixaban, after age 92. As a result, physicians should consider all mortality risks, such as cancer and end-stage kidney disease, when recommending anticoagulants to older adults with AF, the researchers said.

[...] "Many prior studies looking at the benefit of blood thinners found older adults benefit more than younger adults, but they narrowly focus on atrial fibrillation and strokes and don't account for all other health conditions affecting older adults," said lead author Sachin Shah, MD, MPH, assistant professor of medicine at UCSF. "Our study is the first to find that when taking these factors into consideration, anticoagulant benefit actually decreases with age."

Atrial fibrillation affects an estimated 2.2 million Americans, according to the National Stroke Association, and about 15 percent of people who have strokes have AF. The stroke association estimates that up to 80 percent of strokes among people with AF could have been prevented.

While patients age 75 and older are at higher risk for stroke and advised to use anticoagulants, there is little evidence of their net benefit in this population. Advancing age also increases the likelihood of death from non-AF causes, thereby limiting the benefit or harm from AF and anticoagulant treatment.

Journal Reference:

Sachin J. Shah, Daniel E. Singer, Margaret C. Fang, Kristi Reynolds, Alan S. Go, Mark H. Eckman. Net Clinical Benefit of Oral Anticoagulation Among Older Adults With Atrial Fibrillation. Circulation: Cardiovascular Quality and Outcomes, 2019; 12 (11) DOI: 10.1161/CIRCOUTCOMES.119.006212


Original Submission

 
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  • (Score: 1, Informative) by Anonymous Coward on Thursday November 14 2019, @01:06AM (8 children)

    by Anonymous Coward on Thursday November 14 2019, @01:06AM (#920104)

    Hopefully reason will prevail over Big Pharma in the statin fiasco too. (Not holding my breath - but it's coming.)
    From the webpage https://chriskresser.com/the-truth-about-statin-drugs/ [chriskresser.com] (There are many others.)
    1. Statin drugs do not reduce the risk of death in 95% of the population, including healthy men with no pre-existing heart disease, women of any age, and the elderly.
    2. Statin drugs do reduce mortality for young and middle-aged men with pre-existing heart disease, but the benefit is small and not without significant adverse effects, risks and costs.
    3. Aspirin works just as well as statins do for preventing heart disease, and is 20 times more cost effective.

    The studies that get the $attention$ look at a narrow band of preventing cardiovascular disease but conveniently overlook data pointing to the morbidity rate as unchanged (you just die of some other heart related problem).

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  • (Score: 2) by barbara hudson on Thursday November 14 2019, @01:25AM (7 children)

    by barbara hudson (6443) <barbara.Jane.hudson@icloud.com> on Thursday November 14 2019, @01:25AM (#920120) Journal
    Saying aspirin is as effective is a bit misleading - neither statins nor aspirin are effective, and I don't think doctors recommend it any more (if yours still does, you might want a second opinion).
    --
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    • (Score: 0) by Anonymous Coward on Thursday November 14 2019, @07:54AM (2 children)

      by Anonymous Coward on Thursday November 14 2019, @07:54AM (#920247)

      What if I eat aspirins just because I like the taste?

      • (Score: 2) by barbara hudson on Thursday November 14 2019, @01:16PM (1 child)

        by barbara hudson (6443) <barbara.Jane.hudson@icloud.com> on Thursday November 14 2019, @01:16PM (#920319) Journal
        I knew someone who did that. Teeth fell out and they almost died. Same as people who overdosed on Benton because they liked the taste and ended up bombed on the codeine (back in the 70s).
        --
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        • (Score: 0) by Anonymous Coward on Thursday November 14 2019, @05:25PM

          by Anonymous Coward on Thursday November 14 2019, @05:25PM (#920417)

          We all know someone (you) that CHEMICALLY CASTRATED itself with estrogen since you failed as a man lol! You also FAIL as a "woman" you NEUTERED delusional freakazoid! What is is like knowing you are a living mockery. A parody of both a 'woman' or a man? You know that. Everyone knows it about you "TraNsTeSticLe" hohohohoho. Barbara Hudson is a twistoid mental case deluding itself it is a REAL woman. Clue: You will never EVER be able to pass a DNA test due to the fact you do not, nor did you ever, possess female mitochondrial material you crackpot weirdo.

    • (Score: 3, Informative) by choose another one on Thursday November 14 2019, @04:43PM (2 children)

      by choose another one (515) Subscriber Badge on Thursday November 14 2019, @04:43PM (#920400)

      Aspirin and other similar anti-platelets are definitely effective, proven, clinical evidence - almost as good as warfarin in some trials.

      Problem is, exactly the same as warfarin, anti-platelet or anti-coagulation stops clots and therefore increases bleeding risk - by design.

      As you get older you get more fragile generally, the bleeding risk increases, if bleeding does start it's harder to stop (surgical intervention more risky) and eventually the risk equates to the clotting risk meaning it isn't worth taking it.

      I have a serious clotting disorder, I'm on warfarin, for good, as I get older the bleeding risk will increase, things that wouldn't kill others will kill me (a fall, bump on the head, minor car accident -> internal bleeding, etc.). Somewhere I read (although I have failed to chase down the reference) that the most common cause of death for patients with my condition is in fact cerebral haemorrhage. Why? - because we're all on warfarin, and it works so we don't tend to die of clots (or not as much as we would without it) - the warfarin just kills us instead.

    • (Score: 0) by Anonymous Coward on Thursday November 14 2019, @05:29PM

      by Anonymous Coward on Thursday November 14 2019, @05:29PM (#920420)

      So it's true you are a trantesticle then https://soylentnews.org/comments.pl?noupdate=1&sid=34619&page=1&cid=920417#commentwrap [soylentnews.org] ? You are severely insane. Seriously. You had working penis, testicles but sadly a defective brain. It is not logical to try to "fix" parts that work you nutcase.