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Anticoagulation - oral - Management
Basis for recommendation
For people with deep venous thrombosis (DVT) and pulmonary embolism (PE):
- These recommendations are based on Guidelines on oral anticoagulation (warfarin): third edition — 2005 update, published by the British Committee for Standards in Haematology [Baglin et al, 2006], and are consistent with American evidence-based guidelines [Ansell et al, 2008; Kearon et al, 2008].
- The optimal duration of treatment is based on one meta-analysis and two subsequent randomized controlled trials which found courses longer than 1 month reduced the recurrence of DVT and pulmonary embolism, without significantly increasing the risk of bleeding.
- The recommendation for abrupt cessation of warfarin treatment is based on studies using laboratory markers (indicating that acquired rebound hypercoagulable state is rare) and prospective observational studies (which have failed to show a clinical risk).
For people with atrial fibrillation
- This recommendation is based on guidance issued by the National Institute for Health and Clinical Excellence (NICE); Atrial fibrillation: the management of atrial fibrillation [NICE, 2006].
For people with mechanical heart valves
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