Introduction to anticoagulation

  • Anticoagulation may be indicated after an ischaemic stroke if the patient has
    • atrial fibrillation
    • prosthetic heart valves
    • recent myocardial infarction
    • deep vein thrombosis or pulmonary embolism
  • Anticoagulation reduces the risk of another stroke more than antiplatelets such as aspirin in patients with atrial fibrillation
  • Anticoagulation is associated with an increased risk of bleeding
  • Many drugs interact with warfarin to either increase or decrease its effects. Patients should be advised to check if any new medications interact
  • New oral anticoagulants are being developed, which are likely to replace warfarin because the INR does not need to be monitored and they have fewer drug interactions