Dramatically reduce the risk of stroke, systemic embolisms and death in persons with atrial fibrillation.
Relative contraindications for prophylactic or therapeutic anticoagulation include: recent CNS bleed, risk the presence of a spinal or intracerebral lesion with high risk of bleeding, the presence of active bleeding, chronic but significant measurable blood loss, platelet counts below 50,000/mcL the presence of severe platelet dysfunction, recent surgery with high risk of bleeding, underlying coagulopathy, spinal anesthesia or lumbar puncture and high risk for falls.
Combined anticoagulant therapy and aspirin use is associated with the 1.5-2.5 fold increase in bleeding risk in patients with atrial fibrillation and a 2-3 fold increase in patients with ischemic heart disease and prosthetic heart valves.
Among patients with venousthromboembolic disease receiving anticoagulant therapy concomitant use of nonsteroidal anti-inflammatory drugs or aspirin is associated with increased risk of clinically relevant and major bleeding (Davidson BL et al).
Approximately 6 million people in the US receive chronic anticoagulant therapy.
Estimated ten percent of patients on chronic anticoagulation require temporary int2242uption of their therapy to undergo an invasive procedure.
Among patients on oral anticoagulant treatment-apixaban, dabigatran, rivaroxaban, or warfarin with or without PPI therapy: upper gastrointestinal bleeding was the highest in patients prescribed rivaroxaban and lowest in patients prescribed apixaban, and bleeding was lower among patients receiving PPI cotherapy.