Top practice-changing articles over the last two years.

The field of thromboembolic disease and anticoagulation has had critical advances since the Anticoagulation Forum last met (May of 2011). We summarize our "top ten list" of papers that are likely to change the care of the anticoagulated population and improve their outcomes: (1) Patient self-management of their vitamin K antagonist and self monitoring can decrease thromboembolic events; (2) restarting warfarin after gastrointestinal bleeding may decrease mortality; (3) rivaroxaban is effective in the treatment of pulmonary embolism; either (4) apixaban or (5) low-dose aspirin prevented recurrent venous thromboembolic disease after a standard course of therapy; (6) warfarin prevents thrombotic complications up to at least 90 days after bioprosthetic aortic valve replacement; (7) the relative risk reduction of apixaban compared to warfarin is similar across CHADS2 scores, but the absolute risk reduction is higher in high-risk patients; (8) adherence to a warfarin dose-adjustment algorithm improved time in the therapeutic range and thromboembolic outcomes in the RE-LY trial; (9) warfarin had little benefit (if any) over aspirin in patients with decreased ejection fraction and sinus rhythm; (10) adding clopidogrel to aspirin in patients with lacunar infarcts did not reduce the risk of recurrent stroke and increased bleeding.