Should I take Eliquis?

@craes
I think your question should go to a second opinion of a cardiologist. Without us knowing about your medical condition and other medications asking MCC (Mayo Community Connect) is asking suggestions without your medical history nor are we medical doctors. MCC is a great place to get suggestions based on our experiences, and information that you may not be aware of including getting second opinions from medical professionals,

MCC is not Mayo Clinic doctors. It is forum set up by Mayo Clinic for patients to interact with each other for information, experience, etc. not a medical doctor forum. I know this sounds blunt but trying to give you what is in your best interest. What may work for one individual may not be what is good or right for you. That is why you need second opinion from a trusted and experience medical physician with full knowledge of your medical information.

In my opinion and my suggestion, your cardiolgist has a concern for stroke and prescribed Eliquis. If you do not agree, seek a second opinion and get it from a well known, experiences medical experts in that field.

These are my thoughts based on a lot of reading, but with no real expertise backing me up:

There is little or no danger associated with apixaban. It is largely, and almost universally, well tolerated, and it only retards clotting, it does NOT prevent it. This is exactly what you want, and is what it was designed to do.

The medical community goes largely by your CHA2DS2- VASC score:
https://clincalc.com/cardiology/stroke/chadsvasc.aspx
Once your score rises to 1 or above, they get edgy and want to use caution. There are ethical and practical reasons, with the latter meaning liability...and not wanting to break their Hippocratic Oath...to do no harm. Negligence IS harm.

After any amount of AF, your heart begins a slow or a faster process called 'remodeling'. Both its substrate and its morphology begin to change as an adaptive response to the stresses the arrythmia imposes on the myocytes and the valves affected, particularly the mitral valve between that pesky left atrium and its left ventricle neighbor. There is also fibrosis, or simply...scar tissue. This happens inside the atrium, on its inner surfaces, where the strains and stresses are keenly felt. Fibrosis makes the task of fixing you via catheter ablation more difficult. Also, if left to run unchecked, your atrium will enlarge, and that, too, causes fibrosis.

Further, with even a short and distant experience with episodic AF, you run the risk of stroke. In fact, the cardiology field feels that most strokes that happen any time within about six months (!!!!) of your last AF episode, can be attributed, in all probability, to the AF. Not certainly, but the stats suggest rather strongly that,. once you show AF, you go on apixaban or equivalent for life. Some EPs will let you, or agree to let you, go off NOACs (new oral anti-coagulants) if you have no further arrythmia...AND...you have a non-leaking, firmly closed, Watchman device inserted into the left atrial appendage. This is typically after you have had a confirmation TEE (trans-esophageal echocardiogram), and that rarely happens before six months have passed since the installation of the Watchman.

With all that firehose material, may I ask, and I'm not being snide or prying, but why do you think you should not take it?

craces,

Logic dictates another workup by a competent cardiologist ... this could be at Mayo, or any one of a number of competent leading edge medical facilities.

Unless you have the same training as your cardiologist it is pretty dangerous to act on your opinions ... this is your health!

I am not the Mayo Clinic but I’m sure money will get in the decision making. Don’t forget, the shareholders.

Back to the question or comment my cardiologist said no to elequist Too dangerous. Didn’t say why though. So I’m on Coumadin

I worry it’s mostly about the money that can be made from me by both the pharmaceutical company, the rep, and the Dr. it’s a little over $1.700 every 3 months. I have a pacemaker to prevent my heart from dropping below 50 bpm. I take a daily aspirin and am cold a lot when others are hot so I think my bloods thin enough. There isn’t any history of strokes in my family so all of this combined makes me feel like it’s a money thing.

Thank you for this wonderful abstract, as I believe it to be wholly accurate. I stroked ('20), and had two type II MI's from Arrymthia in '22. I have a Watchman from '23. Through the clincalc.com link, I scored a 5. A bit high, eh? I use Aetna for Part D, Drugs, and an NP from there called me, went over my med history, and told me I needed to be on Eliqus or an equivalent. They're so firm on it they're asking my cardiologist to prescribe it. I really appreciate your concise and easy read.
John

Hopefully our moderators can provide you a link to another discussion, going on currently, about where else to acquire apixaban. There's a Canadian lab/epharm that sells to the USA customers with a prescription provided. It runs about $70 for a three month supply...if I recall correctly. LifeRX or something like that. Mods?