ANTICOAGULATION (ORAL)

Definition: To reduce the risk of thromboembolic events when certain risks or conditions are present.

Indication

INR Range

Duration

Atrial fibrillation or flutter

2.0-3.0

Indefinite to age 80 or with history of peripheral embolism or CVA - > age 80 and without these risks use ASA mg/d

Cardiomyopathy with EF < 25%

2.0-3.0

Indefinite weigh against risk of bleeding from falls

DVT/PE 1st episode

2.0-3.0

3-6 months if reversible or time-limited risk

> 6 months if idiopathic

DVT/PE recurrent or continuing risk factor (pelvic malignancy, blood dyscrasia)

2.0-3.0

Indefinite

Mechanical heart valve

2.5-3.5

Indefinite add ASA 81 mg/d if high embolic risk

MI (following acute MI)

2.0-3.0

3 months then ASA 162-325 mg/d indefinitely

Valvular heart disease with history SE

2.0-3.0

Indefinite add ASA 81 mg/d if systemic embolism occurs on Warfarin

References: Geriatrics At Your Fingertips, 2000 Edition, p. 31.

JAGS, Clinical Practice Guidelines, 48:224-227, 2000.

10.03

 

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