Why Anticoagulation Clinic?

Why Anticoagulation Clinic?

Warfarin has a narrow therapeutic window

Low INR -> thromboembolic complications
High INR -> major bleeding

Successful management requires:

  1. Careful monitoring of INR
  2. Ongoing patient education
  3. Good communication with patients

Benefits of Anticoagulant Clinics:

Randomized controlled trials found:

  1. Lower adverse events – thromboembolism and major hemorrhage
  2. Anticoagulant levels within the therapeutic range for a longer period – better control
  3. 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.