Table 6

Indications for Anticoagulation With High Thrombotic Risk

IndicationPatient Characteristics
Mechanical valve prosthesis
  • Mechanical valve + additional thrombotic considerations: AF, CHF, prior stroke/TIA

  • Caged-ball or tilting disc aortic valve prosthesis

  • Stroke/TIA within 6 months

  • AF with CHADS2 score ≥4 (or CHA2DS2-VASc score ≥6) (84)

  • Stroke/TIA within 3 months

  • Stroke risk ≥10% per year

  • Rheumatic valve disease or mitral stenosis

  • VTE within 3 months

  • History of unprovoked or recurrent VTE

  • Active cancer and history of cancer-associated VTE

Prior thromboembolism with interruption of anticoagulation
Left ventricular or left atrial thrombus
Left ventricular assist device (LVAD)

AF = atrial fibrillation; CHF = congestive heart failure; TIA = transient ischemic attack; VTE = venous thromboembolism.