Who should take an anticoagulant?

Donna Hill Howes, RN
Family Practitioner

Warfarin, an anticoagulant, is recommended for people with heart failure, history of a stroke or a TIA (transient ischemic attack), and a history of a pulmonary embolism (blood clot in the lung). The target INR is 2 to 3. (INR is a measure of the blood's tendency to clot. Dabigatran, rivaroxaban, and apixaban are newer oral anticoagulants that do not require monitoring of INR. They are as effective as warfarin and have fewer drug and food interactions. However, they have adverse effects that may limit compliance and are more expensive, and there are no drugs that can reverse their effects.)

Warfarin is also recommended after a heart attack that has severely damaged the front portion of heart (large anterior infarction). It is also advised for people with a blood clot in the left ventricle. Treatment is continued for at least 3 months, with a target INR of 2 to 3.

People with atrial fibrillation are treated with an anticoagulant whether or not sinus rhythm is achieved. There is a high rate of silent recurrence of atrial fibrillation, and it increases the risk of blood clots. If the anticoagulant is warfarin, the INR should be maintained between 2 and 3.

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People who should regularly take an anticoagulant, or blood thinner, include those who have had a DVT (deep vein thrombosis), PE (pulmonary embolism), or an irregular heart beat (Afib for example).

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