Response to warfarin and other oral anticoagulants: Effects of disease states

Background. Warfarin is associated with numerous drug and food interactions , and much attention:has been appropriately focused on this subject. Becaus e several disease states may also affect response to oral anticoagulants, w e present a summary of the literature. Methods. We searched MEDLINE for original articles on die effect of disease states on response to warfarin. Results. Liver disease and thyroid dysfunction are well-documented as affec ting warfarin response. Further study is needed to establish whether febril e illness, congestive heart failure, and other disease states enhance the e ffect of warfarin in some patients. Conclusion. Careful monitoring of anticoagulant therapy in patients with di seases that have the potential to affect warfarin response could increase s afety and efficacy of this important agent.