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Anticoagulation: choosing the optimal anticoagulant.

Publication ,  Journal Article
Hawes, EM; Viera, AJ
Published in: FP Essent
July 2014

The risks of bleeding and thrombosis should be considered in decisions on whether to initiate anticoagulation therapy. Oral anticoagulation is indicated for patients with nonvalvular atrial fibrillation who are at intermediate or high risk of stroke (CHADS2 [Congestive heart failure, Hypertension, Age at least 75 years, Diabetes, previous Stroke or transient ischemic attack] score of 1 or higher). Apixaban, dabigatran, rivaroxaban, or warfarin can be considered for the prevention of stroke and systemic embolism in these patients. Hospitalized patients at high risk of thrombosis should receive prophylaxis with low-molecular-weight heparin, low-dose unfractionated heparin, or fondaparinux, whereas those at low risk should not receive pharmacologic prophylaxis. Pharmacologic prophylaxis with low-molecular-weight heparin or low-dose unfractionated heparin is indicated for patients undergoing nonorthopedic surgery who are at high risk of thrombosis and those undergoing orthopedic surgery whose risk of bleeding is low. Patients presenting with acute coronary syndrome should receive intravenous unfractionated heparin or enoxaparin at hospital admission. Anticoagulation with warfarin is appropriate for patients with mechanical heart valves. Patients with deep venous thrombosis or pulmonary embolism should receive rivaroxaban, dabigatran, or warfarin.

Duke Scholars

Published In

FP Essent

ISSN

2159-3000

Publication Date

July 2014

Volume

422

Start / End Page

18 / 23

Location

United States

Related Subject Headings

  • Thrombosis
  • Stroke
  • Risk Factors
  • Risk Assessment
  • Practice Patterns, Physicians'
  • Postoperative Complications
  • Patient Selection
  • Humans
  • Heart Valve Prosthesis
  • Embolism
 

Citation

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ICMJE
MLA
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Hawes, E. M., & Viera, A. J. (2014). Anticoagulation: choosing the optimal anticoagulant. FP Essent, 422, 18–23.
Hawes, Emily M., and Anthony J. Viera. “Anticoagulation: choosing the optimal anticoagulant.FP Essent 422 (July 2014): 18–23.
Hawes EM, Viera AJ. Anticoagulation: choosing the optimal anticoagulant. FP Essent. 2014 Jul;422:18–23.
Hawes, Emily M., and Anthony J. Viera. “Anticoagulation: choosing the optimal anticoagulant.FP Essent, vol. 422, July 2014, pp. 18–23.
Hawes EM, Viera AJ. Anticoagulation: choosing the optimal anticoagulant. FP Essent. 2014 Jul;422:18–23.

Published In

FP Essent

ISSN

2159-3000

Publication Date

July 2014

Volume

422

Start / End Page

18 / 23

Location

United States

Related Subject Headings

  • Thrombosis
  • Stroke
  • Risk Factors
  • Risk Assessment
  • Practice Patterns, Physicians'
  • Postoperative Complications
  • Patient Selection
  • Humans
  • Heart Valve Prosthesis
  • Embolism