BACKGROUND cost of anticoagulation with dabigatran is largely based on estimation of complication rates derived from clinical trials. OBJECTIVE to investigate cost of anticoagulation with dabigatran in comparison with warfarin in clinical practice. METHODS a prospective observational study of patients with non-vavular atrial fibrillation (NVAF) referred to anticoagulation clinic. Patients w...

BACKGROUND We aimed to determine the effect of excessive anticoagulation on morbidity and mortality in hospitalized patients with major anticoagulant-associated hemorrhage. METHODS We prospectively identified 101 consecutive inpatients admitted to Brigham and Women's Hospital with major bleeding occurring during administration of warfarin sodium, unfractionated heparin (UFH), or low-molecular...

Patients receiving warfarin who have unstable control of anticoagulation have a significantly lower intake of dietary vitamin K compared with their stable counterparts. We hypothesized that supplementation with oral vitamin K would improve stability in patients with previously unstable control of anticoagulation. Seventy warfarin-treated patients with unstable anticoagulation control were rando...

OBJECTIVE To investigate the effectiveness of aspirin and coumarin in preventing thromboembolism in patients with non-rheumatic atrial fibrillation in general practice. DESIGN Randomised controlled trial. PARTICIPANTS 729 patients aged >/=60 years with atrial fibrillation, recruited in general practice, who had no established indication for coumarin. Mean age was 75 years and mean follow up...

PURPOSE This article identifies approaches for implementing an inpatient anticoagulation program involving pharmacists; two successful inpatient anticoagulation programs previously reported in the literature are described with a discussion of steps to consider in developing or expanding such a service. SUMMARY Two institutions implemented pharmacist-managed anticoagulation services. One insti...

Resuming anticoagulation therapy after a potentially life-threatening bleeding complication evokes high anxiety levels among clinicians and patients trying to decide whether resuming oral anticoagulation to prevent devastating and potentially fatal thromboembolic events or discontinuing anticoagulation in hopes of reducing the risk of recurrent bleeding is best. The available evidence favors re...