A 45-year-old patient on estrogen therapy was diagnosed with a deep venous thrombosis in the left leg. After an immediate short regimen of low-molecular-weight heparin (LMWH), their physician offered a choice of extended oral anticoagulant therapy. The patient was given the choice of traditional warfarin therapy or one of the new oral anticoagulants.
Discussion
New oral anticoagulants (NOAC) have become more popular than traditional warfarin therapy because routine laboratory testing is no longer necessary. One factor to consider is lifestyle. In this case, the patient travels for work, and frequent laboratory visits would be inconvenient.
New oral anticoagulants do not usually require laboratory testing for ongoing treatment. However, they are not without risk. Up to 3% of patients on NOAC therapy can experience a significant bleeding event. It is essential to assess your personal risk tolerance.
Consider how you would handle a similar situation. What questions would you ask to make your decision? The following pages offer more information related to this situation.
