Why Anticoagulation Clinic?
|Why Anticoagulation Clinic?
Warfarin has a narrow therapeutic window
Low INR -> thromboembolic complications
High INR -> major bleeding
Successful management requires:
- Careful monitoring of INR
- Ongoing patient education
- Good communication with patients
Benefits of Anticoagulant Clinics:
Randomized controlled trials found:
- Lower adverse events – thromboembolism and major hemorrhage
- Anticoagulant levels within the therapeutic range for a longer period – better control
- Cost reduction and decreased emergency department visits
But the relevance of anticoagulation clinics may come down when non vitamin K anticoagulants which can be taken without monitoring take over. At present they are not useful in prosthetic valve anticoagulation, warfarin is still needed.