Warfarin in non-valvular atrial fibrillation

Area of Science:

• Cardiology
• Pharmacology

Background:

• Novel oral anticoagulants offer alternatives to warfarin for non-valvular atrial fibrillation (AF).
• Challenges with novel anticoagulants, including cost and unresolved issues, necessitate continued evaluation of warfarin.
• Warfarin is expected to remain a primary anticoagulant choice for South African patients with non-valvular AF.

Purpose of the Study:

• To review the correct clinical use of warfarin in non-valvular atrial fibrillation.
• To provide guidance on warfarin management for South African patients.
• To address practical aspects of warfarin therapy, including transitions to/from novel oral anticoagulants.

Main Methods:

• Review of clinical guidelines and literature on warfarin use.
• Discussion of practical management strategies for warfarin therapy.
• Inclusion of specific scenarios such as bleeding and chronic kidney disease.

Main Results:

• Comprehensive guidance on initiating and maintaining warfarin therapy.
• Recommendations for temporary warfarin withdrawal and bleeding management.
• Strategies for switching between warfarin and novel oral anticoagulants.

Conclusions:

• Warfarin's continued importance in non-valvular AF management in South Africa is highlighted.
• Effective clinical use of warfarin requires adherence to established guidelines.
• The article provides a practical resource for clinicians managing patients on warfarin.