A Decision Analytic View of Anticoagulant Prophylaxis for Thromboembolism in Heart Disease

Abstract

The decision whether to employ anticoagulant therapy at a particular point in the course of heart disease rests on a tradeoff between the efficacy of anticoagulants in preventing embolism and the risks of precipitating a hemorrhagic event. The thromboembolic events of concern are usually systemic emboli, but venous thromboembolism, especially recurrent pulmonary emboli, are also of grave concern. The majority of systemic emboli involve the cerebrovascular circulation, and many result in permanent sequelae or death.