Question

A 68-year-old man with atrial fibrillation on warfarin presents with upper gastrointestinal bleeding. His INR is 3.5 and Hb is 82 g/L. Endoscopy reveals a bleeding duodenal ulcer treated with endoscopic therapy. According to current practice, what is the best strategy regarding resumption of anticoagulation for stroke prevention?

Accepted Answer

Delay resumption of warfarin for about 7-14 days, balancing bleeding and thrombotic risk

Answer

Cease warfarin permanently

Answer

Resume warfarin immediately after endoscopy

Answer

Switch to aspirin monotherapy only

Answer

Switch to low molecular weight heparin long term

Practice question