A 45-year-old female patient on estrogen therapy was diagnosed with a deep venous thrombosis in her left leg. After an immediate short regimen of low-molecular-weight heparin (LMWH), her physician offered her a choice of extended oral anticoagulant therapy. She was given the choice of traditional warfarin therapy or one of the new oral anticoagulants.
Discussion
New oral anticoagulants (NOAC) have become more popular when compared to traditional warfarin therapy because of the lack of need for routine laboratory testing. One factor to consider is lifestyle. In this case, the patient travels for work, and frequent laboratory visits would be inconvenient.
The new oral anticoagulants do not usually require laboratory testing for ongoing treatment. However, new oral anticoagulants are not without risk. Up to 3% of patients on NOAC therapy can experience a significant bleeding event. It is important to assess your personal risk tolerance.
Consider how you would handle a similar situation. What questions would you ask in order to make your decision? The following pages offer more information related to this situation.
