Anticoagulation and Antiplatelet Agents

By Dr Graham Beards - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19094276

By Dr Graham Beards - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19094276

 
Kassim NA. The new, direct, target-specific oral anticoagulants. J Appl Hematol [serial online] 2015 [cited 2020 Jun 8];6:141-7. Available from: http://www.jahjournal.org/text.asp?2015/6/4/141/171993

Kassim NA. The new, direct, target-specific oral anticoagulants. J Appl Hematol [serial online] 2015 [cited 2020 Jun 8];6:141-7. Available from: http://www.jahjournal.org/text.asp?2015/6/4/141/171993

 

Warfarin Management Tools

INR Goals Summarized

2.0 to 3.0

  • DVT and/or PE: Therapy duration varies (see chart)

  • Atrial fibrillation: Continue indefinitely

  • Valvular disease

    • Rheumatic mitral disease

    • Bioprosthetic or aortic bileaflet valves in patients with

      • No risk factors, i.e. atrial fibrillation, HFrEF, MI, LAE, endocardial damage

      • No history of embolism while appropriately anticoagulated

2.5 to 3.5: Any prosthetic valve not included in the 2.0 to 3.0 category (see above)

 

Antiplatelet Agents

Clopidogrel Indications

  • ACS: Acute dosing varies

  • Continuous dosing: 75 mg daily

    • Percutaneous coronary intervention: Dual antiplatelet therapy x 12 months and then continue aspirin only

    • Carotid artery atherosclerosis for patient intolerant of aspirin

    • TIA or ischemic stroke

      • Stenosis of 50% to 69%: 21 days

      • Stenosis of 70% to 99%: 90 days