e******e
发帖数: 118 | 1 Pt with afib not on anticoagulation before came with TIA, chads 4, in terms
of A/C, do you start coumadin right away or birding lovenox first?
I know if it is just afib requiring A/C, we can just start coumadin; if it
is just TIA, no need for A/C. What about the above scenario?
Thank u for ur input. | n*******c
发帖数: 501 | 2 I always start warfarin with bridging LWMH because warfarin can cause
transient hypercoagulable state, not because I want A/C to treat TIA.
I have seen one case who was on warfarin for afib but then stopped because
of dental procedure. warfarin was recommenced ?1-2 days after the procedure
with no LWMH cover and he ended up having a pontine infarct. Although I am
not 100% sure if warfarin is the culprit, I would use LWMH cover if it is
not contraindicated. The risk of stroke is small but real. | A*******s
发帖数: 9638 | 3 Agree with newprozac.
Start heparin or LWMH for new onset TIA with A-fib until INR theraputic. | e******e
发帖数: 118 | 4 Thank u for the explanation. What if for pt with chronic rate controlled
afib who is coumadin naive, do u bridge or no? I see a lot of doc start
coumadin directly w/o briding. | A*******s
发帖数: 9638 | 5 If just had a TIA, bridge of course. Otherwise, you may titrate coumadin
slowly.
【在 e******e 的大作中提到】
: Thank u for the explanation. What if for pt with chronic rate controlled
: afib who is coumadin naive, do u bridge or no? I see a lot of doc start
: coumadin directly w/o briding.
| n*******c
发帖数: 501 | 6 Agree. If you want to start warfarin w/o bridging, you should not give
loading dose. | P*********8
发帖数: 168 | 7 if no contraindication, should be on coumadin. Not like DVT/PE, bridging
form heparin or LMWH is not required.
TIA itself does not require AC, should be treated like stroke, start ASA and
statin if not contraindicated.
terms
【在 e******e 的大作中提到】
: Pt with afib not on anticoagulation before came with TIA, chads 4, in terms
: of A/C, do you start coumadin right away or birding lovenox first?
: I know if it is just afib requiring A/C, we can just start coumadin; if it
: is just TIA, no need for A/C. What about the above scenario?
: Thank u for ur input.
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