Document Detail

Managing oral anticoagulation requires expert experience and clinical evidence.
MedLine Citation:
PMID:  16475049     Owner:  NLM     Status:  MEDLINE    
The management of patients on chronic oral anticoagulant therapy, namely Vitamin K antagonists such as warfarin, is often associated with difficult and challenging issues for the healthcare practitioner. Many of these issues, such as warfarin failure or resistance, the optimal warfarin initiation dose, the optimal target International Normalized Ratio in antiphospholipid syndrome, the optimal monitoring frequency and use of point-of-care monitoring, the management of oral anticoagulation during invasive procedures, and the management of over-anticoagulation, have not been evaluated in rigorously-designed clinical trials. The latest American College of Chest Physician recommendations concerning these issues are Grade 2C, the weakest recommendations available. It remains up to the experience and expertise of the individual practitioner along with whatever clinical evidence is available in a particular healthcare environment-especially one associated with an anticoagulant management service-to implement management strategies with respect to these issues in patients on oral anticoagulation.
Alex C Spyropoulos
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  21     ISSN:  0929-5305     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-02-13     Completed Date:  2006-06-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  91-4     Citation Subset:  IM    
Lovelace Sandia Health Systems, Clinical Thrombosis Center, 5400 Gibson Blvd SE, Albuquerque, NM 87108, USA.
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MeSH Terms
Administration, Oral
Anticoagulants / administration & dosage*,  adverse effects
Antiphospholipid Syndrome / drug therapy*
Clinical Trials as Topic
Drug Monitoring* / methods
International Normalized Ratio*
Personal Health Services / methods
Warfarin / administration & dosage*,  adverse effects
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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