Making Decisions About Antithrombotic Therapy in Heart Disease: Decision Analytic and Costeffectiveness Issues

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 thromboembolism and the risks of precipitating a hemorrhagic event. The thromboembolic events of concern are usually systemic, but venous thromboembolism, especially recurrent pulmonary emboli, is also of grave concern. The majority of clinically recognized systemic emboli involve the cerebrovascular circulation, and many result in permanent sequelae or death.