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
(Score: 3, Informative) by choose another one on Thursday November 14 2019, @04:43PM (2 children)
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: 2) by barbara hudson on Thursday November 14 2019, @08:20PM (1 child)
https://www.nbcnews.com/health/heart-health/daily-aspirin-no-longer-recommended-prevent-heart-attacks-healthy-older-n984406 [nbcnews.com]
https://www-m.cnn.com/2019/03/17/health/aspirin-heart-disease-guidelines/index.html?r=https%3A%2F%2Fduckduckgo.com%2F [cnn.com]
https://www.usatoday.com/story/news/health/2019/03/18/aspirin-prevent-heart-attacks-strokes-doctors/3199831002/ [usatoday.com]
https://www.newsmax.com/t/health/article/907477?section=health-news&keywords=daily-aspirin-heart-attack&year=2019&month=03&date=18&id=907477 [newsmax.com]
https://boston.cbslocal.com/2019/03/18/daily-aspirin-heart-attacks-prevent-stroke-study/ [cbslocal.com]
The first 5 of many results for "aspirin no longer recommended for heart". I expect we'll see the same for rat poison (warfarin) at some future date. But for hearts, a daily baby aspirin is now out as a preventative treatment.
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(Score: 3, Informative) by choose another one on Saturday November 16 2019, @03:31PM
When you have a lethal and rare condition you make it your business to be aware and uptodate on it because that keeps you alive. I know more than most doctors (the non-specialists) about what is wrong with me. My information is absolutely fine, and I will be coming off Warfarin when I'm dead or when they invent test and approve something better for my condition - currently the rat poison is all there is.
You know nothing about my condition, I haven't even said what it is, your information is all about the effectiveness of aspirin as a prevention in healthy adults, TFA was about people with AFib and I was talking about other clotting disorders as well - you are claiming I am wrong by talking about something completely different.