An analysis of the lowest effective intensity of prophylactic anticoagulation for patients with nonrheumatic atrial fibrillation
Article Abstract:
Physicians should administer anticoagulation to prevent strokes or hemorrhage in people with atrial fibrillation at a dosage that results in an international normalized prothrombin-time ratio (INR) between 2 and 4. This was demonstrated in a study that compared INRs in 74 people with atrial fibrillation who were hospitalized for a stroke and 222 people hospitalized for other reasons who were also taking anticoagulants. The risk of stroke doubled when the INR fell from 2 to 1.7 and doubled again when it fell to 1.4. Other studies have shown the risk of hemorrhage rises when the INR rises above 4.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1996
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The Scylla and Charybdis of oral anticoagulant treatment
Article Abstract:
Several observational studies have found that anticoagulants should be given to people with atrial fibrillation at a dosage that leads to an international normalized prothrombin-time ratio (INR) between 2 and 4. People with atrial fibrillation have a high risk of stroke and must take anticoagulants to reduce this risk. However, too much anticoagulation could lead to excessive bleeding. One study found that the risk of stroke increased as the INR dropped below 2. Others have found the risk of bleeding increases as the INR rises above 4.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1996
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Acetaminophen and other risk factors for excessive warfarin anticoagulation
Article Abstract:
Several risk factors can cause excessive anticoagulation in patients taking warfarin, thus increasing their risk of bleeding. Warfarin is an anticoagulant and patients' blood levels must not exceed an international normalized ratio (INR) of 4. Researchers compared risk factors in 93 patients with INRs greater than 6 and 196 patients with INRs less than 4. Acetaminophen use was strongly associated with INRs greater than 6. Other drugs can also increase the activity of warfarin, as can diarrhea and advanced cancer.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1998
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