Which factors affect bleeding risk during anticoagulation therapy with warfarin in patients with atrial fibrillation (Afib) (AF)?

Updated: Nov 18, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Several scoring systems have been developed to estimate risk-benefit for warfarin use in AF.

The major adverse effect of anticoagulation therapy with warfarin is bleeding. Factors that increase this risk include the following:

  • History of bleeding (the strongest predictive risk factor)

  • Age older than 75 years

  • Liver or renal disease

  • Malignancy

  • Thrombocytopenia or aspirin use

  • Hypertension

  • Diabetes mellitus

  • Anemia

  • Prior stroke

  • Fall risk

  • Genetic predisposition

  • Supratherapeutic INR

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