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Should the Newer Oral Anticoagulants Be Withheld From Patients With Valvular AF?Anticoagulants in Valvular Atrial Fibrillation?

James E. Dalen, MD, MPH, Master FCCP
Author and Funding Information

From The University of Arizona College of Medicine.

Correspondence to: James E. Dalen, MD, MPH, Master FCCP, The University of Arizona College of Medicine, 5305 Via Velazquez, Tucson, AZ 85750; e-mail: jdalenmd@gmail.com


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;144(2):369-370. doi:10.1378/chest.13-0666
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Extract

I recently saw a patient with atrial fibrillation (AF) in whom anticoagulation with warfarin was particularly problematic. Despite weekly monitoring of his international normalized ratio, his cardiologist was unable to find a regimen that would keep him in the therapeutic range. When he asked his cardiologist about one of the newer anticoagulants that do not require monitoring, the patient was reminded that the omnipresent television commercials specify that these new anticoagulants are for patients with nonvalvular AF. Because the patient has mitral valve disease, the new anticoagulants are not available to him.

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