Aiming for Safe Anticoagulation

Abstract
Since its discovery more than 50 years ago, warfarin has endured as a remarkable drug and is now the 14th-largest-selling medication in the United States. The efficacy of oral anticoagulant therapy in treating and providing prophylaxis against venous thromboembolism and in preventing arterial thromboembolism in patients with atrial fibrillation or prosthetic heart valves is generally accepted. Another indication for warfarin was recently approved by the Food and Drug Administration: the prevention of death, venous thromboembolism, and recurrent infarction after acute myocardial infarction. In relation to other widely prescribed medications, warfarin remains inexpensive (when the costs of laboratory monitoring are disregarded). . . .