Dosing Intensity of Anticoagulants for the Prevention and Treatment of Venous Thromboembolism and the Prevention of Stroke in Atrial Fibrillation: Why is There a Difference?

Results of clinical trials with the old and newer anticoagulants support the recommendation that lower doses (resulting in lower anticoagulant exposure) should be used to prevent venous thrombosis rather than to treat established venous thrombosis or to prevent embolic stroke in atrial fibrillation (AF). In this brief commentary, we will review the evidence for using different dosing regimens for each of the three indications ([Table 1]) and offer potential explanations for these dosing differences.