Introduction to anticoagulation
Please note that this Topic Loop is under review and will be updated shortly to reflect the latest National Stroke Guidelines for Stroke (RCP 2023)
- 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
- Warfarin was previously the most commonly used anticoagulant. Warfarin is a vitamin K antagonist and works by inhibiting vitamin K dependent clotting factors. Warfarin requires regular monitoring and it interacts with many other drugs that either increase or decrease its effects. It can be reversed relatively easily if required.
- Patients should be advised to check if any new medications interact with warfarin
- Newer oral anticoagulants have been developed, which may replace warfarin, because they have fewer drug interactions and require less frequent blood tests. They are known as the Direct Oral Anticoagulants (DOACS).
Page last reviewed: 21 Jul 2023
