Recommendations for Warfarin Therapy
| 2007 Recommendations | 2011 Focused Update Recommendations | Comments |
|---|---|---|
| Class I | ||
| Use of warfarin in conjunction with ASA and/or clopidogrel is associated with an increased risk of bleeding and should be monitored closely. (Level of Evidence: A) | 1. Use of warfarin in conjunction with ASA and/or a thienopyridine agent is associated with an increased risk of bleeding, and patients and clinicians should watch for bleeding, especially gastrointestinal, and seek medical evaluation for evidence of bleeding.13,22,86,134–137 (Level of Evidence: A) | Modified recommendation (updated to include a choice of thienopyridine). |
| Class IIb | ||
| Warfarin either without (INR 2.5 to 3.5) or with low-dose ASA (75 to 81 mg per day; INR 2.0 to 2.5) may be reasonable for patients at high CAD risk and low bleeding risk who do not require or are intolerant of clopidogrel. (Level of Evidence: B) | 1. Warfarin either without (INR 2.5 to 3.5) or with low-dose ASA (75 to 81 mg per day; INR 2.0 to 2.5) may be reasonable for patients at high CAD risk and low bleeding risk who do not require or are intolerant of clopidogrel.138,139 (Level of Evidence: B) | 2007 recommendation remains current. |