The inter-individual variation in warfarin dosing requirements and narrow therapeutic index for anticoagulation necessitates a personalized dosing regimen. Variation in dosing requirements are in part explained by genetic polymorphism in CYP (involved in warfarin metabolism) and VKOR (a warfarin target) genes. A dosing strategy informed by these polymorphism may hold promise to improve anticoagulation control. […]
Tag: warfarin
Does warfarin need to be stopped for device insertion?
Over 1.6 million pacing or cardioverter defibrillator (ICD) devices are implanted worldwide annually and up to 1/3 of this cohort have an indication for long-term anticoagulation therapy. Current guidelines suggest discontinuing the oral anticoagulant and initiating bridging therapy with heparin but this strategy is associated with increased costs, a short but high risk period of […]
Triple therapy post-PCI? WOEST clarifies
20-30% of patients taking oral anticoagulants also have ischaemic heart disease that requires treatment by percutaneous coronary intervention (PCI), thereby necessitating dual anti-platelet therapy to prevent stent thrombosis. However, the combination of dual anti-platelet therapy (DAP) and anti-coagulants is associated with a high annual risk of fatal and non-fatal bleeding episodes. This study hypothesised that […]
Atrial Fibrillation: Women at higher stroke risk
Patients with atrial fibrillation (AF) have a risk of stroke that is five times greater than that of the general population. Moreover, it has previously been described that women with atrial fibrillation have a higher annual rate of stroke than men (3% vs. 1.6%). The reasons for this remain unclear, although previous studies have […]
Apixaban shows promise
Warfarin has been the primary treatment to mitigate the increased risk of stroke associated with atrial fibrillation for more than 40 years. However, up to 30% of patients are not suitable candidates for or are unwilling to receive warfarin therapy despite having a high risk of stroke. A host of new oral agents are now […]