1. < Polymyalgia Rheumatica (PMR)

Any of you with PMR also have afib and on blood thinners?

Posted by vandyms1974 @vandyms1974, Nov 24, 2024

I developed PMR and was prescribed Prednisone. That made a lot of difference. However, I later developed afib and was given Eliquis. Now it is harder to treat the PMR due to the bleeding potential while on Eliquis. I am currently on 1 to 1 &1/2 mg per day and it helps. However, we are considering the use of the Watchman heart implant to possibly get off the Eliquis after a few months. Anyone else been down this path? I am on the fence about the implant. Could it make the afib worse and an antiarrhythmic be needed? Lots of questions!

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

DadCue | @dadcue | Nov 27, 2024
In reply to @navymom154 "I developed A-Fib long before PMR/Pred. It was suggested I get a sleep study done. Turned..." + (show)
@navymom154

I developed A-Fib long before PMR/Pred. It was suggested I get a sleep study done. Turned out I had severe sleep apnea and since using a C-PAP I no longer have A-Fib and am off blood thinners! I'm so glad I took the sleep study advice!

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Interesting because I was diagnosed with sleep apnea after being diagnosed with PMR and being on Prednisone. I guess it is just a matter of prospective on cause and effect. Whatever precedes something gets blamed for being the cause.

As a statistician I know this isn't true. Correlation does NOT equate to causation.

I have a hard time not blaming Prednisone for many things so I apologize if I do. I'm currently off Prednisone and now I'm off 3 blood pressure medication, atorvastatin as well as my blood thinner. To me that is some supportive evidence that Prednisone was causing many things.

I got used to my CPAP machine but more and more -- I don't think I have sleep apnea anymore. At the time sleep apnea was diagnosed, it was said that Prednisone was causing changes to my face and neck area. Prednisone was said to be "exacerbating" if not causing obstructive sleep apnea.

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vandyms1974 | @vandyms1974 | Nov 27, 2024
In reply to @dadcue "I didn't have a-fib but I had other cardiac arrhythmias while on Prednisone. I didn't get..." + (show)
@dadcue

I didn't have a-fib but I had other cardiac arrhythmias while on Prednisone. I didn't get on blood thinners until I had multiple, bilateral and extensive pulmonary embolisms of "unknown etiology." After spending a a couple of days in intensive care, I eventually went home on "warfarin for life." My cardiac abnormalities probably stemmed from elevated blood pressure in excess of 200/100. I developed left ventricular hypertrophy (LVH) from high blood pressure.. A cardiologist started three blood pressure medications. I didn't have much hope that I would ever be able to stop the blood pressure medications and warfarin. Being short of breath with minimal exertion all the time was the worst of it.

Things started to improve after I was able to discontinue Prednisone. At first, I was dizzy all the time and I had to be careful so I wouldn't faint. My blood pressure was getting too low and I was diagnosed with orthostatic hypotension.
https://www.mayoclinic.org/diseases-conditions/orthostatic-hypotension/symptoms-causes/syc-20352548
My blood pressure medications were stopped one by one. Now my blood pressure is a healthy 110/70 with no blood pressure medications. I have bradycardia but that was normal for me when I didn't take prednisone.

After 10+ years on warfarin, the anticoagulation clinic offered Eliquis so I wouldn't need to have my INR checked so often. I was reevaluated for my heart health. When it was learned that I was no longer on Prednisone, it was decided that I no longer needed any blood thinner. Now I'm off warfarin and all my cardiac medications including Atorvastatin in addition to being off prednisone.

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Wow, that is progress! Thank you for sharing that. Thankful you were able to turn this all around. Blessings.

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vandyms1974 | @vandyms1974 | Nov 27, 2024

Thanks for that. Is it the pred or the PMR that lead to afib? Somewhere I read that PMR can impact the sinus nodes. Who knows? I think PMR is a bear!!

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vandyms1974 | @vandyms1974 | Nov 27, 2024
In reply to @tapamil65 "I have AFIb and PMR. Trying to wean down the prednisone, currently at 9mg going to..." + (show)
@tapamil65

I have AFIb and PMR. Trying to wean down the prednisone, currently at 9mg going to 8.5 today and reducing by 1/2 mg a month. It’s such a slow process. But have tried 1 mg a month and always flare at about 5. Trying a slower taper. My doc has never mentioned the danger of afib and taking Eliquis with prednisone. I learn more from all of you. Now I am worried!!!!!

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I am sorry, but don't worry. I have been on Pred for over two years and on Eliquis for over one year. I just wanted to pursue the Watchman to get off Eliquis, but am a little concerned about going into my heart, which as far as I know is physically sound, The electrical part is causing problems. My doctors are so concerned about the stroke potential without Eliquis. We will keep looking into it. It is harder to treat PMR while on Eliquis.

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1 reply
DadCue | @dadcue | Nov 27, 2024
In reply to @vandyms1974 "Thanks for that. Is it the pred or the PMR that lead to afib? Somewhere I..." + (show)
@vandyms1974

Thanks for that. Is it the pred or the PMR that lead to afib? Somewhere I read that PMR can impact the sinus nodes. Who knows? I think PMR is a bear!!

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"Thanks for that. Is it the pred or the PMR that lead to afib? Somewhere I read that PMR can impact the sinus nodes. Who knows? I think PMR is a bear!!"
-------------------
PMR is a bear! Inflammation can cause a lot of things so PMR inflammtion can expose many things. However, prednisone has been researched thoroughly over the decades since it was first used for RA.
https://www.verywellhealth.com/prednisone-heart-rate-5113682
----------------------
I have learned to never underestimate what Prednisone does in the body. I believe it is all related to cortisol which Prednisone replaces. Look at some of the effects that cortisol has in the body.
https://my.clevelandclinic.org/health/articles/22187-cortisol

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megz | @megz | Nov 27, 2024
In reply to @vandyms1974 "I am sorry, but don't worry. I have been on Pred for over two years and..." + (show)
@vandyms1974

I am sorry, but don't worry. I have been on Pred for over two years and on Eliquis for over one year. I just wanted to pursue the Watchman to get off Eliquis, but am a little concerned about going into my heart, which as far as I know is physically sound, The electrical part is causing problems. My doctors are so concerned about the stroke potential without Eliquis. We will keep looking into it. It is harder to treat PMR while on Eliquis.

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What is it about taking Eliquis that makes it harder to treat PMR?

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vandyms1974 | @vandyms1974 | Dec 15, 2024
In reply to @megz "I'm on Eliquis and prednisone together after a DVT (thrombosis) 8mths ago. When I had no..." + (show)
@megz

I'm on Eliquis and prednisone together after a DVT (thrombosis) 8mths ago. When I had no choice but to start on a blood thinner, my doctor mentioned a problem with taking the blood thinner Warfarin with prednisone. If we have to take a blood thinner with prednisone, Eliquis is apparently the better one to take. They work differently.

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Thank you so much for this information. I take Eliquis, but recently had the Watchman Implant. I pray that was the best decision. However, a low dose aspirin has been controversial recently.
Always something!
Blessings on your journey.

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nanniepie | @nanniepie | Dec 15, 2024

Hi. I have afib and have a pacemaker. I’m on eliquis 5 mg two times a day I think I noticed a bit more afib since on prednisone but then I think it could be anxiety as this PMR is new to me 3 months and so much is being thrown at me I feel at times my head is spinning

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orangecat | @orangecat | Dec 20, 2024

Hello everyone. I am a 70 year old male in pretty good health (so I think.) I have A-fib and take Eliquis. My PMR diagnosis is still being worked up but it sure is looking to be a good diagnosis. I had sent messages to all my specialists that my rheumatologist was starting me on prednisone. It is my cardiologist that is saying (for now) "hold on". I am going to say that my PMR started last October with severe pain in my left bicep. Pain and range of motion limitations quickly moved to the other side bicep and shoulders. Now it is also in my hips. About 5 months ago I developed swelling (both sides) in my calfs, ankles, feet. A cause could not be found. I went in to my shoulder specialist for steroid injections in my shoulders and in one of the 4 fingers I exhibit trigger finger. Two days later I noticed my legs were not so swollen. By the end of the 5th day all swelling was gone. My major symptom is the bicep pain that i mention along with the feeling that I just had a major gym workout, my body is so sore. I hope to by coming to this forum learn about the PMR condition. I see many writing about flare ups and good and bad days. For me it has been one continuous bad day since last October. Thanks.

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3 replies
DadCue | @dadcue | Dec 20, 2024
In reply to @orangecat "Hello everyone. I am a 70 year old male in pretty good health (so I think.)..." + (show)
@orangecat

Hello everyone. I am a 70 year old male in pretty good health (so I think.) I have A-fib and take Eliquis. My PMR diagnosis is still being worked up but it sure is looking to be a good diagnosis. I had sent messages to all my specialists that my rheumatologist was starting me on prednisone. It is my cardiologist that is saying (for now) "hold on". I am going to say that my PMR started last October with severe pain in my left bicep. Pain and range of motion limitations quickly moved to the other side bicep and shoulders. Now it is also in my hips. About 5 months ago I developed swelling (both sides) in my calfs, ankles, feet. A cause could not be found. I went in to my shoulder specialist for steroid injections in my shoulders and in one of the 4 fingers I exhibit trigger finger. Two days later I noticed my legs were not so swollen. By the end of the 5th day all swelling was gone. My major symptom is the bicep pain that i mention along with the feeling that I just had a major gym workout, my body is so sore. I hope to by coming to this forum learn about the PMR condition. I see many writing about flare ups and good and bad days. For me it has been one continuous bad day since last October. Thanks.

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I'm just wondering why it is the cardiologist that is saying "hold on." Does the cardiologist have reservations about you starting prednisone?

There is some debate about prednisone "causing" or exacerbating pre-existing a-fib. There are other cardiovascular side effects of being on Prednisone. One side of the debate says prednisone is the blame and the other side says inflammation from PMR is the blame. I'm mostly curious about what your cardiologist thinks.

I don't take any side in the debate other than thinking maybe it is the combination of the systemic inflammation of PMR and being on Prednisone. I don't have a-fib but I had cardiovascular problems since PMR was diagnosed and starting Prednisone.

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